24-color me surprised, the articles about mifepristone were retracted by publisher

Shocked, I am shocked. This is heavy sarcasm.

Does anyone remember the debunked articles by Andrew Wakefield that began the most recent wave of anti-vaxers nonsense with a widely exposed fraudulent article in the Lancet conflating autism with childhood vaccines? And how every parent clutched their child to their breast and decided then and there that of course the man was telling the truth. With nothing underneath him but air? Yeah, him.

Healthcare workers, such as myself, have been educating parents about how safe vaccines are ever since. But the idea was like an earworm and refused to die. As a society, we are still dealing with the fallout and the consequences of this. Current measles outbreak numbers do not lie.

Herd immunity works very well. But the public has to be 1) vaccinated for it to work and 2) be protective of those who cannot get vaccinated, like the very young, the people who are anaphylactically allergic to the vaccines, or those who cannot otherwise take the vaccines.

Think of what the planet just went through with covid and you have a good idea of how damaging and heartless this was. People who didn’t get the widely available and FREE covid vaccines extended the pandemic.

To be blunt, autism is NOT caused by vaccines. To mislead the public into believing that was a gross malpractice on the former Dr. Wakefield’s part.

Well.

The 2021 paper that the Texas judge used in a ruling against the use of mifepristone has been yanked. By the publisher. Retracted by the publisher. What the judge did was bend the facts to make his ruling that mifepristone was dangerous and should be stopped. And his ruling was appealed and stayed and overturned. Which is what was the intention.

The case that is in front of the U.S. Supreme Court right this very second.

I’ve said it before, over and over again. This lunacy is a war against women and is about trying to control more than half of the population. Control is at the root of this.

Will they care that the original ruling was based on a retracted by the publisher paper?

It remains to be seen. I have an idea about what will happen. Don’t you?

I hope I am wrong.

Tuesday Top of Mind 1/30/24-1460 days of covid

On my Facebook memories from 2023, the Dispatches from the Evening Shift post was a Monday musing from 1/30/23 was 1095 days of covid. I thought, well, it’s been a minute since I wrote about covid.

Let me take the local temperature of covid.

Yes, there was a winter surge. As predicted. The hospitals were full; the hospital I work at seems to be always full. There was flu, and RSV, and covid. Just like last year.

According to the CDC Covid Data Tracker, there have been 26,607 hospitalizations for covid in the US in the week of January 20, 2024. This is down from 28,323 hospitalizations for covid in the US in the week of January 22, 2023. The weekly death rate has been averaging 1800 American dead each week. That is still a substantial number, for all that the public is bored hearing about covid. The most current number of dead, as reported, which is suspect because of the patchwork reporting done by some states, is one million, one hundred seventy-two thousand, two hundred two.

The CDC Codiv Data Tracker has improved its reporting and ease of information finding. This was always my second choice for covid data. RIP Johns Hopkins Covid Dashboard.

Covid is still here. People are still dying.

The best way to protect yourself and your family members is to make sure you’ve had the most current booster. Get tested if you are sick. Stay home if you are sick. If you feel the need to go to the hospital because of difficulty breathing, or low oxygen saturation, go to the hospital. According to my county’s tracker, 12.8% of those who presented to the hospital were admitted.

Not very exciting, I know. But important to keep yourself and your loved ones safe.

No, I can’t believe I am still writing about this shit nearly 4 years after the first recognition that this might be bad. It’s not as bad as it was, but it is still not good.

Post-it Sunday 1/21/24-Make it bigger!

The gown card reads “Dear Doctors, JUST MAKE THE INCISION BIGGER!!!”

Mic drop.

I don’t know who needs to hear this but, yeah, struggling for 20 minutes because you made the incision a quarter inch smaller than normal.

What do you get out of it? Bragging rights in the doctor’s lounge? A free all-expense paid golf trip at the next conference? The love and devotion of your patients?

The push in the OR is toward smaller and smaller. Smaller incisions, smaller case times, smaller.

Just smaller.

And, yeah, that should be shorter case times but it didn’t fit the theme, you know?

I see you struggling with the smaller incisions that you make.

Yeah, patients may like a smaller incision, but how much smaller can you go? And still have the proper exposure to have to do what you are operating to do? Patients probably will be happier with a regular-sized incision and a smaller hospital bill. Because you ramp up their time under anesthesia and therefore the cost of the procedure while you struggle with exposure

I know that you know the incision is smaller. But the patient is not going to know. The incision can only stretch so much.

We were doing a case in the middle of the night. Of course, it was the middle of the night, you work nights, Kate! But the surgeon was struggling with taking out the specimen from the incision size and I mean, struggling! Thirty minutes they struggled and sweated and fought to get the specimen out, me watching from the sidelines, the sterile scrub tech helping them. Finally, they gave up and started pulling the specimen out in pieces. I asked gently if a slightly bigger incision would’ve been helpful. They sighed and said it would’ve been easier. I asked if the patient was going to notice that their incision was mm longer if they had gone for the bigger incision. They said no.

I said nothing else. I think the point had been made.

Two weeks later we had a nearly identical case, same team, same surgeon. When they had localized the specimen they asked for the knife and said to me “See, I can learn.” They made the incision slightly bigger and were able to only work on getting the specimen out for 6 minutes.

Sometimes you just need to make the incision bigger.

It isn’t a slight on the surgeon; just the facts.

Tuesday Top of Mind 12/5/23-Gap in the data

My brain is right now about finding data gaps in the nursing research. This is to aid me in my doctoral classes and I think I’ve found one. Both in the doctoral classes.

And in the current covid pandemic numbers.

What covid pandemic numbers?

You say you haven’t seen any covid pandemic numbers in months. You even didn’t know it was still a thing. Mostly because you don’t care. It has killed as many as it is going to kill and other things are more important to you.

I get it, I do. But that’s just it; we don’t know about current numbers. All we get are dribs and drabs of numbers, sometimes, if the wind is right. Otherwise, no one is reporting numbers right now.

At a glance at the current numbers here in my town, the data is lagging a bit. The last numbers are from November 3-November 16 and apparently, the covid risk is low. 11% of those who presented to the hospital with covid like symptoms got admitted, but the covid risk is low.

79% of the covid samples are from 2 dominant strains-Omicron XBB and Omicron XE. The most current variant that is in the news is BA.2.6, according to the CDC. Even that update is from 11/27/23.

That is the point.

The data are weak. When we get it at all.

There certainly is a lot more to capture our attention. Is covid a victim of the news cycle because there is something sexier to talk about that gets attention?

Yep.

Inflation, the holidays, and wars.

Lions, tigers, and bears indeed.

Oh my.