25- RIP United States Women’s Research, 1990-2025

RIP to women’s research, 1990-2025.

Although you were only active for a handful of years, compared to all the research that has been done on men (cough, cough, erectile dysfunction), you will be missed.

I realize that it wasn’t until the early 2020s that period products such as tampons and pads were even tested using human blood, but you taught us so much.

I realize that it was until 2013 that the first woman crash test dummy was made and used in crash tests, but for a brief moment the world realized that women are not just small men.

Some other things you’ve given the people with the female parts were life changing and life saving. I am writing about the BRCA and BRCA1 gene research that showed that some breast cancers are linked to uterine and ovarian cancers. This was in 1998. This led to identifying possible antibody treatments for those cancers.

I put 1990 as your birthday because that is when it became law that women and minorities are to be included in all clinical research. Before that, the NIH guidelines for inclusion of women were not included in research, although the policy had been changed in 1989. The inclusion of women and minorities in research allows the analysis of if the variables being studied affect women and minorities in a different way than other (male) participants. Programs were initiated to recruit and retain women for clinical trials.

I further realize that in 2001 the Institute of Medicine published “Exploring the Biological Contributions to Human Health: Does Sex Matter”. In this paper, the researchers examined biology from the cellular level up and concluded that the different hormones of the different genders DID impact medication response. We, as women, knew that of course there was a difference but the pharmacology companies didn’t even bother to research that until the late 1990s.

Say it with me, women are not just small men.

I realize that women are mysterious and “icky” to those in power. And worth only the output of our uterus. Why should they bother to test medications and tests and everything else with the lens that female and male are not the same? You taught them differently.

I put 2025 as your ending date because, well, we all know what is happening on the U.S. Federal level. With their pushback of all things gender and race that are not white and male.

Why? Hell if I know. Female are icky.

But research into gender disparities and racial disparities have been under attack since January 20, 2025. We all know what happened that day.

Since January, according to an article in the Atlantic, hundreds of research studies into health disparities and transgender health had their granted grant money yanked away from them. The agency officials who supported these research studies have suddenly lost their jobs.

With the new NIH Director the phrase of the day, the phrase that will guide research is “scientifically justified”.

What the hell does that mean?

Again, hell if I know. But I think it means whatever the hell will allow them to change focus on research. No longer will females and racial issue apply to their new male centered, white centered research focus.

Because after all, men are the most important gender/sex there is. Except if it was assigned female at birth. And white men are the most extra special of all.

With a cherry on top! And topless women to bathe them.

eye roll

RIP to the U.S. research focus on women’s body and racial disparities.

We hardly knew you.

May the future be bright. May the other half of this country wake up from the spell it is under and realize that this is stupid.

May other countries fly your flag proudly.

If you need me, I’m going to be listening to the No Cure For Cancer comedy album by Dr. Denis Leary.

And considering if this new hellscape of research has room for me. I know, probably not because I am a female and I have ideas.

Medical non-fiction book review 8/17/25- Beyond Limits: Stories of Third Trimester Abortion Care

Beyond Limits: Stories of Third Trimester Abortion Care by Shelley Sella, MD. Published 2025.

Do I have any idea how this book got on my radar? Nope, none.

But I am not surprised I had it to read. I believe I was perusing the new and notable section of the library. You know, the section where they put all the recently returned and the new and shiny books? Yeah, there.

I am very interested in feminine medical care, especially in these fraught times. Especially when females are under attack by those who should care for us in the governments. Yes, plural. State governments are as complicit as the federal.

But this cannot have escaped Dispatch readers’ attention. Nor the side I am on.

The woman’s.

Always.

This was a quick read. That is not saying it was an easy read. It was definitely not an easy read.

However, I believe it to be an important one.

In these stories, families cared for regardless of their feeling on abortion. That is, until they need one.

In this book, the author is careful to tell all the stories but focuses on the maternal indication, meaning that to be denied an abortion would have substantial negative effects on their life, or the fetal indication, meaning that there is something deathly wrong with the baby. One woman is anti-abortion until she needs one. Another is anti-abortion but understands that this is in the child’s best interest. Unsurprisingly, the second family have the support of their pastor and that of their community.

Dr. Sella points out when the mother has religious beliefs that conflict with abortion, pain, distress, and anxiety are heightened. And she takes steps to lessen all of these. She gives each couple a book about others who have to make the decision of peace for their baby, wanted as they are, loved as they are. It is “A Time to Decide, a Time to Heal: For Parents Making Difficult Decisions about the Babies They Love”. This book is written by Molly A, Minnick, MSW, Kathleen J. Delp, ACSW, and Mary C. Ciotti, MD.

For me this is take away from the entire book. Yes, the baby is dying, but not because of anything the mother did, and not because they aren’t loved and it sucks but the parents will get through this and by undergoing a late 2nd and 3rd trimester abortion, they are giving babies peace and not a life of struggle and pain and death. Or the mother faces certain hardships or death to carry the baby to term.

This doctor and clinic take steps to decrease the mother’s anxiety, with lowered lights, soothing music, and medication as needed to keep the patient less anxious and to decrease the pain. A counselor is also present. This is about supporting the mother who has chosen a better end for their wanted baby. Every person is there for support of the mother.

This book is part history lesson about the abortion care in the U.S. From the 1970s, all the way through the current Dobbs decision. Dr. Sella takes us along on her personal journey and history. Interspersed with the real time four days it takes to complete a third trimester abortion. These chapters focus on four mothers who are at the clinic in search of care.

The author was adamant that she not go to medical school, that she could provide care and counseling away from the bedside. But the doctors were still in charge and she realized that she wanted to support at bedside and give her patients back the power.

She gives the patients scripts to use when talking about why they are no longer pregnant. “The baby was sick and we went for testing. The baby didn’t make it. It’s hard for me to talk about right now.

What struck me as especially compassionate was the discussion she led with the families of what would happen after the now still birthed baby. All of it to make sure the families were as supported as they wanted.

Pictures, both medical of anomalies and commemorative are taken after the stillbirth. These pictures are always taken and kept in the chart, even if the woman says they aren’t wanted. That way they can give them to the family if they change their mind.

Taking pictures of a deceased infant has come a long way in the 25 years I’ve been a nurse. Now there can be photo shoots, and keeping the body in the room on a cold cot for as long as necessary. I have had many conversations with women, patients and friends alike, who have told me they would have like a picture. Or a remembrance of some kind so that others know that this baby was here, and was loved, and died. Because they haven’t forgotten.

Footprints and handprints can be taken. She counsels the families that if the pregnancy is ended closer to term, there will be a birth certificate and a death certificate. The mothers will have the option to view the baby the next day, after they’ve rested and recovered a little. But there is no pressure to do so. Of the four mothers the book is about, only one does so.

In the beginning and through the process, she counsels the families in a group, so that they have support and can feel comfortable sharing their stories.

She leads them through the expected question of will the baby feel any pain. She explains that is why the heart is stopped, through medication, before the delivery can take place. If there is no heartbeat, there can be no pain. Fetal pain is a subject that I have heard a lot about, probably because of the anti-abortion insistence that there is pain for a fetus during an abortion. There is no studies backing that up.

Through the entire book, the author is open to ongoing changes in American law and what these challenges mean to abortion care. And the unceasing anti-abortion backlash, up to an including the release of her personal home address leading to protests in her neighborhood.

Up to and including the murder of her mentor at the hands of an anti-abortion zealot. Inside of his personal church, where he was an usher. What these zealots fail to comprehend is that these are human beings they are calling murderers, and pigs, and more, This is a human being that they killed to satisfy their hate. As if by killing the head of the serpent they would kill the clinic and the need for this level of abortion care.

I think the best way to end was with what one of the fathers said when it was over and they were preparing to leave “Quite frankly, my religion has let me down.”

There are reasons listed in the book as to why these four women are seeking third trimester abortion care. Their babies are ill or the procedure is done to support the mother or the procedure is done to protect the life of the mother and she can now undergo additional cancer care. Dr. Sella ends each procedure four day period with a final meeting with the families.

There are several reasons to have a third trimester abortion. Some are fetal abnormalities incompatible with life. Some are maternal cancers or heart problems. Some are dealt blows by life such as rape or abuse. The reasons are the woman’s alone.

I am a firm believer that personal stories can change mountains and make the explaining of third term abortion need impactful. The personal stories and names, changed though I am sure they are, humanize the patients and give voice to the circumstances that led them to make the decisions they do.

This was one of the best medical non-fiction books that I’ve read. I will be recommending it to all the OB and Labor and Delivery nurses I know.

School Me Saturday 8/16/25- AI is Making People Dumber

AI was thrust upon an unknowing public in late November 2022.

All of a sudden AI was EVERYWHERE!

In our search engines. You no longer could run a simple search without AI thrusting itself into the conversation. Uninvited or not. Frankly, it was giving Clippy vibes.

In our “art”. Yes, the quotes are important. Or should it be an asterisk? Also AI art is slop. By that I mean it is crap. Shoddily done, hallucinatory, and ubiquitous. Not to mention obvious.

In our daily planner. Some people began using AI immediately as an assistant. To keep track of their meetings, to bounce ideas off of, and to help write.

Students began using AI to cheat. They didn’t do the assignment. They asked a program, one that has known hallucinatory proclivities (they all do, no matter what people are saying), to write their assignments. And then they were just copy pasting the results into their papers.

When artists and writers objected to their works being used to “train” these large language models, the programmers started to feed the models crap. And the hallucinatory problem got even worse.

And the models started spouting the nonsense it was being fed and some people took that as truth.

I have been invited to use AI to write my thesis. No thank you. The Big Write will be by my own hands and out of my own brain. No large language models needed here.

AI output is only as good as the material that is used to create it. And so much of that is terrible. I would hazard a guess that it is all terrible.

Ooh, you can give a pretend sex doll a third breast. Why not go whole hog and give the bytes four breasts. Or is that too bestiality coded for you?

There is even a name for the phenomenon of the human brain on AI. The phenomenon is split into what the researchers explain are the three main problems.

There is the cognitive offloading. This is when you ask AI to do so many tasks for you, you forget how to do them for yourself. Instead of engaging in the multiple decisions that everyday tasks demand of us, you cede this power over to the machine
There is skill erosion. Simply put this the decreased ability to do the skills that you rely on the program to do for you. Alexa started this cascade. In this the ability to critically evaluate information and come to conclusions is missing.
There are generational gaps. Much like introducing the computer in the 1980s, and the cell phone in the 1990s, and the smart phone in the 2010s, earlier generations who are not born into the AI generation don’t depend on it as much. I have seen this in the subsequent nursing generations. And it is scary how they depend on their AI assisted searches.

All of this results in a population and a generation who is unable to reason, unable to perform simple tasks, and can’t evaluate the results they do get for clarity and for correctness (truth) of the information given.

The best day of the last 6 months was when I found out how to disable the AI search. I taught Chrome how to disengage from AI searching. And I think my searches are better and more complete this way.

This information is from a study as reported by the Forbes Magazine.

FFS Friday 8/15/25- SuperFAKE peace talks

Does anyone else get the sense that the sham going on in Alaska where our president and Russia’s president are meeting over RUSSIA’S sham of a war with Ukraine is a sham?

That is it fake?

Like the badly made consumer dupes that are flooding the stores, homes, parties?

Yeah, me too.

In fact, I am seeing a cheap knock off of the 2004 movie Mean Girls where the Plastics try and hold onto their power over the rest of the student body.

Also insert every single teenaged movie since the inception of the movie.

I am getting a strong sense of both presidents giggling over the death toll in Ukraine.

As they do their hair and make up and try on outfit after outfit. And talk about the killing of innocent people in Ukraine. They might also talk about the SuperFake take over of DC by the president’s thugs. But probably not.

These fake peace talks are definitely giving slumber party antics.

Breathlessly the press is hanging on their every word and action and inaction. The nonevent has been spoken about in reverent tones for weeks. All the world’s reporters are in faithful attendance.

Dance they will.

Nothing will be decided.

The killing of innocent Ukrainians will still go on.

The absurdly trumped up war that Russia’s president started will go on.

Something has to take the world’s attention off the files, after all. As if it could. You know the files I am talking about. How could you not?

I am also getting a whiff of desperation out of both of them. While people die at home and in Ukraine and Gaza, they put on this spectacle.

After all “All the world’s a stage”. Written by William Shakespeare, spoken by Jaques in As You Like It.

Popcorn, anyone?

Cookie Thursday 8/14/25- Unicorn Farts

Many moons ago I made Moose Farts for a December Cookie Thursday is a Thing. I made them because I thought they were funny.

And they were popular.

It’s a simple recipe, graham cracker crumbs, coconut, sweetened condensed milk, chocolate chips, more graham crackers crumbs for rolling. But it was a lot of fun to do.

Now we are in August and the theme is No Heat. I considered resurrecting the Moose Farts when I saw a similar recipe for Unicorn Farts.

This tickled my funny bone.

Similar recipe with white chocolate chips and rainbow sprinkles to roll the balls in.

But if I am not experimenting then why am I making cookies?

Enter edible glitter!

Part of the baking pantry. I picked it up because I thought it would be useful for CTIAT at some point. In reality, this is why half of the stuff is in the baking pantry. You know, just in case I figure out how I’m going to turn it into cookies or I have an idea for a theme and I need to start gathering supplies.

Thankfully, I have a baking pantry and I have the disposable income to be able to pick up interesting (to me) ingredients with the eye to a someday cookie.

But finally, it is the edible glitter’s time to, well, shine.

The resulting make is hilarious and just plain fun to look at. Although the colors were not as sparkly in the batter as they were in the jar, it is still fun to do.

I hope they make my coworkers smile.

Call Secrets of the OR #4- Every call shift will end… Tomorrow!

The shift will end
Tomorrow
Bet your bottom dollar
That tomorrow
There’ll be sleep!

Just thinkin’ about shift end
Clears away the cobwebs
And the sorrow
’til there’s none!

When I’m stuck in a shift
That’s long
And forever
I just stick out my chin
And grin,
And say,
Oh.

The call will end
Tomorrow
So I’ve got to hang on ’til tomorrow
Come what may!

Tomorrow!
Tomorrow!
I will sleep
Tomorrow!
Sleep’s only a shift away!

Apologies to Martin Shaman and Charles Strouse for co-opting and re-writing their hit “Tomorrow” from the Broadway musical Annie.

As a night shifter, I know that sleep is very important. And some nights we don’t get a lot of it. But that is the nature of the call shift. Sometimes there isn’t a lot of sleep, and sometimes it is a full night of it. You have to be able to roll with the schedule.

The first thing my university advisor asks when she sees me is “How’s the sleep? Are you getting enough of it?” Yes, Dr. Advisor, I am getting enough sleep. I have data points to share if you are interested. Maybe I should make it into a graph for show and tell purposes.

That being said, and knowing that not everyone tracks your own sleep patterns, there are some things that can be done in your sleep environment to prepare yourself for good sleep.

Is the room cool enough? A University of Texas sleep specialist, Dr. Okeanis Vauu, reported that sleeping in a cool dark room is recommended. After all, our brain wants a cooler temperature while we sleep. This information is from a UT article on sleep after the spring forward time change.

But it is definitely appropriate for sleeping after a call shift.

The dark room during the day may be harder to accomplish. I have purchased black out curtains until I am blue in the face but they are never dark enough. Next I found and purchased black out blinds that you cut to size. I cut and installed these after the first month I was on call.

Instant bliss. Not to mention cooler.

In the summer, I also put up heavy curtains in the adjoining bath because of the afternoon sun that 1) heats up the small room, and 2) is blindingly bright.

My husband works afternoons/nights and is glad for the additional window coverings.

We don’t have children to get off to school or children at home. Unless you count the cat, who insists that I get out of bed by 0800 every morning, whether or not I’ve worked the night before. But I have heard that can be a barrier for some.

Sleep when you can. Some people can go right to bed when they get home and this is a good habit to get into.

Because you never know when the next case will pop up. There have been times that I’ve been home and in bed for 15 minutes and the darned pager went off again. And I head back to the hospital for another case.

Thankfully those kind of nights are hopefully far apart. And if it is a string of late nights just remember that day shift will be in a 0700 to relieve you so you can go home and sleep.

No bad pattern lasts forever. Some last longer than most but that’s call life.

I find it best not to focus on the sleep you’re missing but instead focus on the good sleep you will get the next day because you won’t be responsible for day cases. And the hospital won’t be ringing you up with add ons.

Remember, there is always a shift end. There is also a finite amount of time that the case volume can hurt you and stop you from sleeping.

These tips are coming from a call afficionado: make your room as dark as you can, and make your room as cool as you can. Fans are a good help here.

And take the afternoon nap when you are able to. Especially if the house is still and silent because everyone else is away at school or work.

Pay attention to your sleep hygiene and practices while on call. Well, any night really, but especially on call.

Call is only a sleep debt if you want it to be.

Tuesday Top of Mind 8/12/2025- Vaccine lies lead to deadly shooting at the CDC

The original title of this post was Panic at the CDC, with a subtitle of no, this ain’t no disco.

Then I thought better. Time to call the vaccine lies what they are, lies. According to the Merriam Webster dictionary the definition of a lie is to “make an untrue statement with the intent to deceive”.

We need to start naming the lies.

None of this namby-pamby “mistruths”, “states without evidence”, “mislead”, “false”, and “fabrications”. All of those words mean the same thing. That someone is not being honest with you *cough, cough, RFK Jr., Fox News* for their own benefit.

Use the word lie(s). Tell it like it is.

It is a good rule of thumb to interrogate your feelings about what you are being told. And also consider the motive behind the one telling you these “truths”. Is it to make you mad? Is it to make you do something that you would not normally do? Such as shoot up the very place that works, and has worked since 1946, to keep the public safe.

This is about a man who was poisoned by the media he was ingesting, not the vaccine that he receive. He thought, probably because that is what he was told, that the vaccine was making him depressed and suicidal.

So, emboldened by the lies that were being told to him at the highest levels and the news, the shooter gathered up his guns and went to kill the very thing he blamed for how his life had gone off the rails.

Never mind that the CDC had been actively working to keep him alive and in good health.

No.

He went to the CDC campus in Atlanta, Georgia and fired 180 rounds into the buildings. He broke 150 windows by firing indiscriminately at four buildings. He was not on the CDC campus, instead firing from the second floor of a CVS across the street.

He also killed a first responder, a Dekalb police officer by the name of David Rose. This was a man who will be missed by his wife and children. He was shot responding to the shooting.

This is an ongoing story and investigation. However, it is also a moment of reflection.

I certainly hope those who are spewing anti-vaccine lies and rhetoric do not sleep easy knowing that their reckless lies and breathless new reports caused this.

According to the CDC website, and the various vaccine makers such as Pfizer and Moderna, depression and suicidal ideation is not a side effect of the vaccines.

And no, I will not be naming the coward who thought it was a good idea to listen to the lies and act upon them. That is readily available.

As always when you are confronted with a news report, Facebook post, text from a friend, consider who your anger benefits.

For fuck’s sake, stop calling it misinformation and use the word lie!

FFS Friday 8/8/25- Forced Removal is Fairness Denied

I have thought about this all day. I have thought about how to approach writing about it. I have thought about all the the F words I wanted to use. I have felt compassion for these individuals impacted. I have felt rage at those who deny those who have bled for this country and served it honorably.

I am referring to the announcement that the Air Force is early denying retirement to all of its transgender members who have between 15 and 18 years of military service. They are being forced out with no retirement benefits. According to a Guardian article even those who were approved for temporary early retirement has had the rug pulled out from under them.

And then I remembered that cruelty is the point with this bastards.

No matter that the enlisted swore to uphold the Constitution, and would obey the President and the officers above them. All they wanted to do was continue to serve their country.
No matter that the oath of office for officers (yes they are different) is that they will support and defend the Constitution, while bearing allegiance to the country.

No, these individuals served as trans members of the military, proudly, for YEARS. And then an ill wind appeared and blew it all to hell. Because the ill wind is a petty little bitch and must destroy what they don’t understand.

To recap, trans members of the Air Force who have served the country and upheld their oaths, enlisted and officer alike, have bled in service of the country, have died for their country, have continued to serve under those who do not understand, who have done their best for the Constitution and their country were targeted for attack under the current administration. Some held strong to get to their 20. Others opted to take early retirement, unable to bear the strain of the unrighteous attacks from those who should be supporting them.

To me, they were forced out. In fact they were told to leave, that they were an abomination.

All they wanted to do was serve.

In 1993, 18 year old me, newly graduated, newly moved across the country to Nebraska, newly a college student, newly dressed in uniform, stood proudly on the wool rug in my detachment’s captain’s office, raised my right hand, and swore the oath of office. I was determined to be a career officer, to study hard, to be the best nurse I could be, to protect and care for servicemen in my care. I was excited to be among other cadets as we all learned what it meant to be an officer and how to support the Constitution to the best of our abilities and with our lives if needed.

This was not to be as I suffered an Air Force career injury due to some ripped up dorm stairs the next year and I was invited to leave as I could no longer fulfill my part of the oral contract. I was weeks away from bootcamp.

What they are doing now is barbaric and is spitting on the graves of all who willingly served before.

Forced removal is fairness denied. No matter that they took the enlisted oath or the oath of office. No matter that they were under attack by those who should have cared for them. No matter that as they had the country’s back in war times, the country decided they were nothing and flicked them off like a cigarette butt when you are done smoking it.

Are you paying attention yet?

I fear that next target will be the women of child bearing age so that they can go home and have babies.

Cookie Thursday 8/7/2025- S’mores treats

August is, as is traditional for Cookie Thursday is a Thing, No Heat Month.

Of course, you wouldn’t know that by the weather this past four days.

Rainy, humid, slightly cooler.

Slightly.

It is tradition, as I’ve said, for August to be the month where I do not turn on my oven.

Like, at all.

With the Thursday before the start of school for most of the schools around here on August 21 and the department has an ice cream social on that day, that leaves me only 3 CTIATs.

This week is a Rice Krispies knock off. Well, the same recipe with a different cereal.

What is more summer late night than s’mores?

Not much.

You know when the temperature is a bit cooler in the evenings but still dark enough to see the fireflies? Yeah, that.

And what goes best with summer late night around a campfire?

S’mores.

I happened upon a Malt-O-Meal bagged S’more cereal. Graham cracker cereal, mini marshmallows, and chocolate balls. Perfect for a Rice Krispies knock off.

But, me being me, I added chocolate chips as I was stirring in the cereal.

Because why not?

Call secrets of the OR #3- Positivity is a must

This is what I alluded to all the way back in call secrets of the OR #1 when I told the surgeon that I approach each case with optimism and I do not dwell on the possibilities.

Not a lot of people like call.

I get this.

However, I think it is because their attitude is wrong.

In case after case after case, the surgeon talks about what can go wrong during the surgery. Before the incision is even made.

I let them grouse and complain and say that they are missing sleep. They list off the complications that could happen. Not will, but could. Yes, yes, we all are missing sleep. I let them get it out of their system. There is a LOT of complaining.

And then I hit them with “But what if none of that happens?”

What if the appendix is sitting on top of their bowel, just ready to be plucked?

What if I have everything in the room for every eventuality and therefore you are not delayed?

What if I can get you back in bed in 90 minutes, 60 if it is an uncomplicated appendix?

Don’t get me wrong, sometimes the nights are very long and I don’t see my bed until after day shift starts. And my cat, who has boundary issues, demands that I get up and touch the food in her dish at 0800, even if I’ve just gotten into bed. Sometimes the case devolves into a messy one and I don’t have everything they need. Sometimes the case devolves into a real shit show and now I have to man the phones to arrange for a higher level of care bed in the intensive care unit.

Sometimes not cool stuff does happen. But not every time. And certainly, not every night.

What if by naming the bad outcome you are dreading makes it happen? What if by naming the bad outcome you are dreading makes it not happen.

Call is a craps shoot. With a 20 sided die. Sometimes you get a natural 1 and it all goes to hell. But there is an equal chance of a nat-20 and the incarcerated hernia reduces itself as the patient goes off to sleep.

Yes, this can happen.

Don’t you see? By steeling yourself that the bad thing will always happen, you cut yourself off from the possibility that it won’t.

I admit that sometimes I am aggressively positive. Which can irritate a surgeon or a coworker. I know this and I will not be working on it.

I just shrug and say, “Oh well. Better luck next time.”