26- Shillers gonna shill, no matter who it kills

To shill, according to the Merriam-Webster dictionary, is to act as a decoy (pitchman or gambler) or the one who makes a sales pitch or serves as a promoter.

In the early 1900s the shiller was regarded as a con artist, specifically one who worked with another person(s) whose entire goal was to take people’s money.

Robert F. Kennedy, Jr., is a shill.

He glommed onto Andrew Wakefield’s dishonest lies about the correlation of vaccines and autism as early as 2005 (according to Factcheck.org).. But he is no stranger to conspiracy theories, believing that the CIA killed his uncle and his father. And that Wi-Fi radiation and 5G cause cancer. And that HIV is not the only cause of AIDS.

All of this without evidence. Well, evidence other people can see, anyway.

He also thinks he is smarter than all the scientists in the world because, and I want to get this quote right, “I don’t necessarily believe all the scientists, because I can read science myself. That’s what I do for a living. I read science critically.” The quotes are from a New Yorker interview in July.

No, sir. That is not what you do. You may understand the words individually (maybe), but you are no scientist.

You are trying to keep and maintain the interest of the population, using lies and deceit and double speaking to do it. And your vast incompetence of understanding what you are reading.

People, babies, have died because of you.

He and his ilk at MAHA are definitely behind yesterday’s Executive Order decreasing the number of vaccines for babies and children from 18-11. Reminder EOs are not law, they are wishes.

I will repeat what countless others have said, more succinctly, and with more grace than I, vaccines do not cause autism. How many more times do we have to say it?

There is no scientific PROOF! There is no scientific DATA! Many, many, many scientific studies have been done. Millions of children have been studied, even in other countries, have been studied, sometimes over a long period of time (researchers call this a longitudinal study). And every single one of them say no, there is no correlation to autism and vaccines.

What will happen next is that parents will get confused and children will not be vaccinated according the vaccination schedule as written.

That means that more children have to get more shots, which may lead to a mistrust in doctors because to go to the doctor means they get a shot. News flash, people don’t like to do something that causes discomfort, even and especially children.

That means more parents will have to juggle their schedule and take precious time off of work to take the children to these unnecessary appointments. Could people lose their jobs over this? Probably.

The whole reason this was done under an Executive Order is that the science and the literature does not back any of this up. So they had to go full wish mode to bend doctors to the will of the madmen.

Scientists, doctors, nurses, and more are SCREAMING don’t do this!

But they don’t care.

They would rather torture a child, set them up for a life long fear of doctors, get their parents fired so that someone has to stay home with the child (don’t act like we don’t see the endgame here) than follow the science they don’t understand.

Normally I would close by saying I’m sorry that you don’t understand.

All I can say is trust the people who do understand and not conmen who are out there trying to extend their fifteen minutes of fame.

Trust the scientist, not the shiller.

Tuesday Top of Mind 8/4/26- Mid summer public health round up

Yes, it absolutely sucks balls that I have to research and write about this.

Rapid fire as that is the only way I can stomach it.

The cyclosporiasis outbreak? Yeah, that one. The one that has led to lettuce distrust and also severe GI symptoms? The one that every comic is making shitty jokes about? The first TWO deaths have been announced in Michigan. The suspected source company had been named and then, just as quickly, declared innocent for the “false positive”. The outbreak is still spreading. (NBC News)

Covid is making its annual summer return. According to the CDC, infections are growing in 41 states. North Carolina is one of them. You know what I am going to say next. Stay home if you feel ill, stay 6 feet away from others who are ill. Mask if you have to go out. WASH YOUR HANDS!

All the covid era nurses I know are now dealing with resurgent PTSD from last week’s hearing. Again, you know the one. I, myself, am so very bleeping angry. A showman amount of bullshit from people who weren’t there and never were. And then the blow-up on Sunday between the DHHS secretary and Dana Bash was icing. He claimed that ICUs were empty of covid patients during 2020 and the hospital workers, nurses and respiratory therapists and doctors and more, all spoke with one voice “What the fuck did you just say?”

More performative theater on DHHS’s part.

Ebola is still very much a thing. As of July 30th, there have been a total of 3605 confirmed cases with 1587 deaths in the Democratic Republic of the Congo. Do the math- that is a 44% death rate. (WHO)

Tick borne diseases are on the rise, because, you guessed it, climate change is allowing the ticks to migrate somewhere where they shouldn’t be.

And then there is all the smoke. From the wildfires in Canada and much of the lower 48. It is less of a what’s on fire now and more of a what isn’t on fire question. Wear a mask if the air is unhealthy due to air quality standards, stay inside, don’t do heavy exercise or work outside.

Who am I kidding? The same anti mask idiots will be out in force for this too.

ugh

I’m sure there is more.

Like the heat and drought everywhere. Can’t wait to see the outcomes from a self-injury like that.

double ugh

Edit August 4, 2026 @1742

Yep, I forgot measles.

What else is there to say besides screaming into the void.

The US is on the cusp of losing the measles eradication status. And it is deserved.

The total number of measles cases for 2026 surpasses all of 2025. In AUGUST.

And also 2025 was the most measles cases that the US has clocked in THREE decades. Thirty fucking years.

Congratulations, you idiots.

FFS Friday 7/31/26- Fauci, the man who saved America

I watched every minute of the excruciating senate covid response hearing where they tried to scapegoat Dr. Anthony Fauci by laying the all the blame on his shoulders.

It was disgusting and every single senator who lambasted the man who saved America during the darkest time in US memory should be ashamed.

They won’t be.

They will go home to whatever swamp they dragged themselves out of and crow to their dwindling fans that they stood up against the scientist who saved us all during covid. I write dwindling because they are facing and dying from the consequences of their anti mask, anti science bullshit.

According to a paper in the journal Nature, public health disparities show a worsening health and higher mortality than liberals. This started in the 2010s and has been widening. This gap is first explained away by the demographic realignment where unhealthy individuals turned conservative. Now it is is clear that the declining trust in the medicine and science among the conservatives is leading to their higher death rates.

Of course.

Too bad they have to drag the rest of us down too.

Dr. Anthony Fauci did the best he could with the information available to him in a rapidly devolving infectious course. Of course the information changed daily, sometimes hourly, and the recommendations changed too. Which is apparently his besetting sin.

The United States was not the first country to go into lockdown. Far from it. Wuhan, China started the lockdown cascade on January 23rd, followed by other cities in China. The first European country to go into lockdown was Italy on March 10th. The US didn’t go into lockdown at any time. Different areas of the country went into lockdown at different times.

Yes, this sucked. It might have sucked to be at home, safe.

While those of us who worked the front lines and the bedsides of the dying were not safe.

This attack on the substance of a man like Dr. Anthony Fauci, who has always only tried to help, is disgusting.

But the ravening mobs must have their ounce of flesh.

But let’s play through what might’ve happened if hospitals didn’t lock down and stop visiting hours. Those visitors might have been infected, who would go home and infect others, who would go out and infect others, and so on. This is why the hospitals limited family, and why the operating rooms limited surgeries except for the urgent and the dying.

I am going to hold both hands over your mouth when I tell you that what we went through as Americans was the absolute best case scenario. It could have been so much worse and a higher death count than 1.2 million Americans.

Everything that has happened since then has been in response to an unfathomable tragedy. Inflation, the 2020 and 2024 elections, the stock market… all of them have roots in the covid pandemic response.

Unless you were on the frontlines of the pandemic, working in a hospital, working at a grocery store, working without a safety net so that others could be safe, I don’t want to hear about how it is all Fauci’s fault.

I regard him as the covid pandemic hero. He was a singular person that served as the face of the pandemic in the US and now they want to excoriate him for it.

Dumb fucking morons who wouldn’t understand science if it bit them on the mouth but they are sure quick to bite the helping hand, aren’t they?

They are also quick to raise the ire of all of us who worked through it. There has been a wave of support for Dr. Anthony Fauci and I will absolutely add my voice to theirs in saying this man was the hero of the pandemic. And if you think otherwise, kindly pound salt.

Or, using smaller words and less of an analogy, keep Dr. Fauci’s name out of your mouth.

Tuesday Top of Mind 7/14/26- Endometriosis can be diagnosed with a saliva test

New hopeful diagnostics tools for endometriosis diagnosis are out. There is a possible blood test and a possible blood test.

This is amazing.

It is early days yet and, of course testing needs to be done but in the research study I have read the blood test can be effective in identifying more than 95% of patients.

Currently, the road to an endometriosis diagnosis is long and the definitive diagnosis is made through laparoscopic surgery.

How long?

As many as 10 years can pass for a woman to be misunderstood, thought to be drug seeking, passed from doctor to doctor, denied the definitive laparoscopic surgery by insurance companies, more pain, more abnormal bleeding, more trips to the ER, more doctors, more insurance denials of care until, exhausted, the woman is finally diagnosed.

How long?

A long fucking time.

It is estimated that the incidence of endometriosis in women is between 6.4% and 11%. And that is just in the US and Canada.

Endometriosis affects women worldwide. Of all age groups, but is more prevalent in childbearing age. And, goodie goodie gumdrops, the incidence is rising and they don’t know why.

But what they don’t tell you in nursing school is that men can be diagnosed with endometriosis too. This is vanishingly rare

But typical of today’s healthcare.

Endometriosis, which has affected millions of women per year for years has only had proper attention paid to it. By proper attention I mean research dollars and even a new understanding of endometriosis as a systemic disease, not unlike an auto-immune disorder after a very small amount of men were impacted. (less than 20)

But a woman is “crazy” for seeking care for debilitating pain.

Right?

Oh, and those 10 years that endometriosis goes undiagnosed? Yeah, those are years where it is growing unchecked. And can impact a woman’s fertility and the health of ALL abdominal organs. Yes, I mean every single one- liver, stomach, pancreas, spleen, uterus, fallopian tubes, colon, small bowel, bladder and ovaries. The endometrium can escape and grow anywhere. And can lead to spots of the endometriosis being burned away by cautery or even laser. I have run the carbon dioxide laser during many laparoscopic endometriosis surgeries.

Did I mention the pain? I remember one of my classmates in 2000 get into a shouting match with our instructor when the instructor tried to tell her she knew nothing about endometriosis. Mic drop, the classmate had been suffering for YEARS and had just received a diagnosis in the late 1990s. I think her knowledge and experience was more up to date than the middle aged male instructor.

I believe this news is hopeful.

I just wish women had been believed and the work had been done years before this.

Think of all the suffering that could have been avoided.

Cyclosporiasis is spreading soon to a state near you

Cyclosporiasis is an intestinal infection that is caused by a parasite. It has been reported in 32 states as of July 10, 2026.

This is not infectious. This means it does not spread person to person. The oocytes have to be injested.

This is caused by a teeny tiny oocyte (egg) that has been found on fruit and vegetables. Kind of like e. coli in bagged lettuce but so much worse.

Like e. coli it is spread through food or water that has been contaminated with fecal matter.

You know, poop.

The products on the hot seat this time is various types of imported fresh produce. According to the CDC includes raspberries, basil, snow peas, mesclun lettuce, and cilantro.

Never has there been a better time to avoid cilantro because it tastes like soap. But that just be me.

Washing your produce with chlorine is not enough. Washing your produce period is not enough.

Cooking your vegetables to 60-70 degrees Celsius is recommended. That means 140-158 degrees Fahrenheit. For at least 15 minutes.

There is an antibiotic available that the infection is susceptible to but you have to be diagnosed to treat it.

And a whole lot of people are suffering in silence at home.

That brings me to how wide is this infection?
No one knows for sure.

How many people have gotten sick?
No one knows for sure because people suffer at home without telling anyone.

In all probability it is vastly underreported.

The most common symptom is watery diarrhea with frequent and possibly explosive bowel movements. Leading to embarrassment and the not seeking help.

Drink your fluids.

But the real question is why.

Did the DOGE cuts/RFK gutting of the public health infrastructure of last year cause this?
I and all the scientists who have been warning of an outbreak like this give a deafening YES. And they certainly stopped monitoring the infection in 2025.

Hands up if you knew this would happen.

And say it with me “You dumb fucks!”

Tuesday Top of Mind 6/30/26- It’s hot! Damn hot!

To quote Adrian Cronauer “Fool, it’s hot! I told you again! Were you born on the sun! It’s damn hot! So damn hot!”

That is, of course, taken from Good Morning, Vietnam. And is in fact the scene that Robin Williams riffed off the temperature in Vietnam and set the audience screaming with laughter.

Hot is no laughing matter. Hot and humid is another step down the ladder into hell.

The World Health Organization attributes 1300 deaths in Europe due to this most recent heat wave. Most of the deaths are over 65.

We were just in Virginia, on vacation, and the hottest dang day of the ENTIRE trip was the day we have all bought tickets to Williamsburg. It was going to be 95 with at least 70% humidity. I had warned everyone the week before that the temperature was not going to be what they were used to. As the nurse on the trip, I recommended lots and lots of fluids, reflecting hats, getting out of the sun in the middle of the day, and lot of breaks.

The day we went to amusement park I backpacked in 12 bottles of water.

Right now, half of the US is under a heat dome. Here in North Carolina, we are expecting highs to crest over 100 degrees. For several days in a row. Including over the 4th of July.

Stay inside in the middle of the day.

Drink lots of fluids. And eat fluid containing foods like watermelon.

Do not mow the grass in the middle of the day. Your HOA will probably care about that but I certainly do not.

Wear loose fitting clothing, including a hat, in lighter colors.

Cover your windows that are sun facing.

Fans are your friends.

Speaking of friends, don’t forget to take care of the pets. The asphalt will be really freaking hot on your dog’s paws. It can be as hot as 140 degrees. Stick to the grass.

I’ve already set up the wildlife watering station for the birds, squirrels, etc. that come into our neighborhood. They are hot too. And thirsty.

Heat stroke is no joke. Nether is hot exhaustion.

Monitor yourself and your loved ones.

You should drink enough fluids to counter the fluid loss from sweat.

Humid hot is sneaky and will overwhelm you before you know it.

Have some water. Your kidneys will thank you.

Stay inside where it is cooler. Watch Good Morning Vietnam. Or cue up No Where to Run To by Martha and the Vandellas.

If you know, you know.

Call bootcamp’s next step- Epic optimization

I do a one on one call bootcamp for the operating room. I have done this for years, far longer than I’ve been in the call position. I also did a LOT of buddy call. Habit, you know.

I got an email about AORN EXPO 2027 in Philadelphia. This was an email looking for abstracts for podium presentations due at the end of the month. The abstract for poster presentation, the one I am most familiar with, is due on July 20.

A good call bootcamp takes about an hour and a half. I gauge the new nurse’s familiarity with call.

And then we begin and it is NOT with a call to the nursing supervisor.

I start with showing them the Call Preserver binder that is behind the OR desk. This is the book that I’ve mocked up that is basically a FAQ, with explicitly explained steps. I give them a copy of the “My pager has gone off, now what?” This explains, in detail, the different steps of being called in and what can be expected of them as the call in one.

Next, I optimize everyone’s Epic program for them. Together we move things around, hide other things that they’ll never use, and find the ER dashboard. This is also where I amaze them by adding two sections to their flowsheet section they had no idea of. These are the perinatal post-mortem for miscarriages or D&Es (within the bounds by our state law), or the hysteroscopy flowsheets that does the math for you. Of the fifteen nurses I’ve done bootcamp with zero have known that the hysteroscopy flowsheet exists.

I explain useful things that are within Epic and I explain to them. Like the Bedboard, an at a glance depiction of the hospital. We discuss what the colors of the different rooms and how to differentiate the different units. I highlight that this is the best place to look for beds if the patient is going to be admitted and why it is important to know what higher level of care beds are available. This is where I indicate it is useful to call the supervisor to “reserve” a bed in ICU, or, if the ICU is full, to alert them to the need for an ICU bed.

Other than that, I try not to bother the nursing supervisor. They have an entire hospital to keep up on.

I explain how to schedule a case on the Snapboard. If the surgeon has put it in. If the surgeon has not, we talk about how to create a case and the questions to ask a surgeon about the case. By this I mean instrumentation desired for a fracture, or robot availability.

We talk about what if it is a surgeon we’ve never heard of and what to do to make sure they have privileges to do a case at the hospital. Because if they are not credentialed to work at our hospital, via temporary status or courtesy status, it is technically assault if they operated at the hospital. Pearls are usually clutched in this part of the talk. We all want to take care of patients, including the docs on call. It is a paperwork issue, mostly, but I’ve had to refuse a surgeon or two when they didn’t have any privileges or status at the hospital.

Many of the things in the Call Preserver is how to deal with unfrequently asked questions. I update the book frequently, especially if there is a change in policy around anything to do with the hospital.

As the PACU nurses won’t be called until 30 minutes before they are needed by the call nurse, I explain to them about Quick Prep and why the 8 fields that are to be filled out are better than the 30 fields that ACU does when they prep a patient.

Our consents are now electronic and have been for over a year. I show them the iPads that patients use to electronically sign the consent. This usually yields questions about what if no one is there for the patient and they can’t sign the consent. This leads to a conversation about who can sign a consent legally for you in the state.

The Epic optimization takes about 1/3 of the hour.

All along the way, I am answering questions and giving them real world examples.

Tuesday Top of Mind 5/26/26- North Carolina House Bill 1232

To these 2 chuckleheads in the NC state house life begins at conception.

Who wants to tell them that 25% of those lives don’t make it through no fault of the carrier?

These 2 idiots propose a constitutional amendment to the NC constitution that declares “LIFE BEGINS AT CONCEPTION”.

Yes, the capital letters are mandatory.

This would mean that a fertilized egg that has not been implanted would be recognized as a legal person. And anyone who “willfully destroys” that fertilized egg could be charged with first degree murder. Which is a capital offense. Which means the death penalty is on the table.

Beyond that, there is a deadly force clause. Which means that “any person has the right to defend the life of another person, ‘even by the use of deadly force if necessary'”.

Right.

Which makes all abortion providers liable to be assassinated because their killer(s) were only defending the life of another person. Meaning the fertilized egg that may or may not be in the uterus. And may or may not be more than 8 cells.

Every single health care provider would be at risk.

I’ve participated in abortions as the circulating nurse in the operating room.

And what about those 25% of concepted cells that fail to implant, or fail to grow, or reside in the fallopian tube where they are an active danger to the coman?

Would we then have marauders who are thugs sent out because someone was disappointed that there was a miscarriage?

Probably, we are in the South.

Eight people have been murdered in the US for providing abortion care. What about their rights?

Or does the miniscule, hard to see with a naked eye clump of cells trump all of our rights?

Is that it?

No, it is about control.

Because IUDs and other medication that work by limiting implantation would be on the chopping block in this insane bill.

So would birth control itself.

They will say that this is not about birth control or IUDs or IVF. Of course they will. Whatever to get this bill passed and in front of the largely unknowing public. And then it is open season on healthcare workers.

I did bring up the murder of a nurse and the attempted murder of a healthcare worker in a meeting of highly educated nurses this week. You know, the ones I wrote about last Tuesday? it was appropriate because we were talking about hospital safety. Yeah, no one blinked and they just went on to the next topic after saying that is why we have security guards.

Tuesday Top of Mind 5/5/26- Further bullshit about vaccines

News came out last month that the expected March Covid report would not be released.

Because of joint shenanigans at the CDC, the FDA and the DHS.

They don’t want us to know that the covid vaccine remains safe and is an effective way to not end up in the hospital if you contract covid.

The FDA is also actively blocking the publication of research findings that the covid and the shingles vaccines were safe.

Why?

Who the fuck knows.

Probably because the good news in the report that the vaccines are safe and effective run counter to their fairy/horror tale that they tell themselves that vaccines are bad. The same bullshit they feed to unsuspected people who just want to do the right thing for their families.

This is not the promised transperency.

I wrote recently about how we are not being told the entire story. How you need to read up on what is being missed or delayed or held back or misconstrued. How to find trusted sources. How to not believe what the administration wants you to believe.

Double that.

Hell, triple that.

If you need some sources that I’ve vetted and explored, just ask. I will tell you.

Read the studies that are being blocked yourself. Read the abstract, it contains most of the information that you are searching for.

Or read/watch other’s reactions to the studies. I particularly like Dr. Zach Rubin, the Unbiased Science, Your Local Epidemiologist, and even the Alt National Park Services page on Facebook.

Again, we only being served the pablum that they want us to eat and swallow wholeheartedly.

It might not be the truth.

They are suppressing the truth and the studies.

But these and other pages and substacks are trying to get the information out to us.

You know, so we can make our own decisions.

After all, that is what they say with their whole chests.

But you can’t make an informed decision with half of the facts.

Call Secrets of the OR- Do not assume that the case will be less than posted

There is a universal truth for charge nurses. MDs might be less than truthful to get what they want.

A surgeon might whine and complain and complain some more that they absolutely need to be out by 1400. Never the six cases.

I’ve written about that before.

It is usually about flights.

Of fancy maybe.

The inverse is the surgeon who spies a very very very very minute gap in the schedule. And bluffs the charge nurse that they can absolutely do a 2 hour case in 20 minutes.

Balderdash.

It’s giving desperate. It’s giving Druzilla and Anastasia as they chop off bits of their feet to fit inside the glass slipper. Because their mother told them to to snare the prince.

The only prince around here is the sweet sweet spare time that I imagine all surgeons desire.

99% of these cases run over. And tee time is missed. And TEA time is missed. And flights that never existed are missed.

Mostly because the doctor doesn’t want to wait.

I say put them to work. Give them a mop or a wiping cloth for the room that the last patient vacated 30 seconds before. Show them how to bag trash. Show them where to put the trash.

And watch their head explode when you say that the products used have a 10 minute dry time.

Most importantly, remind them that the consent for the surgery that you both know very well will take longer than the 30 minutes promised. That consent must be signed. And the H&P written.

Or, you know, make them answer the phone that is ringing every 5 seconds. You could do.

We’ve had Epic for more than 10 years now. That is a lot of time for the computer to learn average case times and also be more truthful about how long a surgery will really take.

Surgeons don’t like being told no. But the downstream patients will appreciate you not letting them squeeze in a case that is going to take 10 minutes max.

Notice how the time goes down with each iteration.

Yeah, so do the charge nurses.