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.

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.”

Medical fiction and non-fiction book report 8/3/25- Little Miss Diagnosed by Dr. Erin Nance

Something happened during the pandemic.

People got bored.

A lot.

Even healthcare professionals.

And they turned to YouTube and Instagram and TikTok to make reels as a way to release the pandemic pressure and to make us smile.

Dr. Erin Nance was one of these.

She is a double board certified orthopedic hand surgeon. This is her story.

She is also big into treating the undiagnosed and unheralded medical problems of women. Because, you see, she was also dismissed because of her gender in her internship selection. And she knows that many women are dismissed because of their gender when they seek medical care.

I like and admire that.

We all know that surgery is my favorite. But my especial favorite is hand surgery. I have stared down other orthopedic surgeons who wanted to bump a finger amputation because to them it is just a hand. Yeah, that is like calling brain surgery easy.

Shortly after starting at the regional orthopedic hospitals after we moved across the country I was offered and subsequently took on the hand service line. This means that I was responsible to knowing everything about the hand surgeons and the hand surgeries. I also ordered specialized sutures for the hand surgeons. Healthcare being healthcare I was also handed the trauma service line and the pediatric service line. This means that I had to know all of the fixation types to fix a broken bone or to fix a tendon.

It was a lot.

Hands hold and sculpt and cook and soothe and comfort. Hell, the opposable thumb is what allows for much of what the hand is capable. Opposable thumb means that you are able to bend, twist and touch the tip of your thumb to all of your other fingers. This allows us to hold a pen, or a paintbrush and create art or books. When they talk of fine motor skills, this is what they mean.

Put your hand out and take a look at it. Spread your fingers wide and note which muscles of your forearm control which finger. There are 23 bones in your hand. The bones of your fingers, we call these phalanges, each have a tendon attached to them that enables their movement.

I waited and waited and waited to get this book from the library. I have seen a few of her videos on Facebook and I found her to be warm and genuine and have really great stories. I was very excited to read her book.

I received and read her book in one sitting. Not hard because it is less than 250 pages.

As much as I was looking forward to this book, I didn’t like it as much as I was expecting.

There isn’t much of a narrative throughline. There is her brother Kevin who suffered a devastating spinal injury with spinal cord fracture on her very first day of her internship. The scenes written with him were warm and just on the side of Pollyanna puke that I live on. He pops up periodically as Dr. Nance celebrates his wins.

The stories are not told in a chronological order. This kind of bugged me and some of the stories I am familiar with through her stories were missing. Ones that I think would’ve made compelling reading.

Her very short chapter on the other denizens of the operating room left much to be desired. According to her explanation I, as an OR nurse, comfort patients and fetch them warm blankets and are a soothing presence as anesthesia is started. And my mood sets the mood for the entire room.

Yes, but.

She could have definitely gone deeper here.

The book was less surgery details focused and more her process focus through internship, residency and hanging out her shingle immediately after residency. This means that she opened her own practice because she couldn’t find a niche.

I can respect that.

But I didn’t like this book as much as I expected because it was so shallow. There isn’t a lot of detail that screams real life. This is a good book for those who are not in the know. There isn’t a lot of gore or death or broken bones.

I picked up the book expecting some of that and it did not deliver. That is what I meant by shallow. There are depths that I wish had been plumbed.

FFS Friday 8/1/25-F-in Cowards #4

Oh, my god, they pulled up the corpse of Elmo and shot him again.

Shield your eyes, children.

And just like that the path in childhood has been closed to CHILDREN. No more education programs that are not ads for toys or ads for movies or just plain ads.

The Corporation for Public Broadcasting announced today that it has begun shut down procedures. People are being laid off, with the corporation shuttering in January 2026.

The CPB was authorized by Congress in the 1967 Public Broadcasting Act to ensure that everyone, and I mean everyone, has access to non-commercial, high-quality content and telecommunications. They used 70% of their own funding to support more than 1500 locally owned radio and television stations.

This means that the shows and the broadcasts are not trying to sell you anything.

Unlike the rest of the world.

Every minute of every day.

But, alas, this is no more because congress yanked its funding in order to give money to millionaires and billionaires in the form of tax credits.

“But, but you will get a tax credit too!”

pffft, I’ll believe it when I see it.

We certainly did not receive any money during the pandemic and those 2017 “tax cuts”? Our taxes went up. By a lot. Many thousands of dollars a lot.

No, I don’t believe you when you tell me that it was worth it.

Fucking cowards.

Mr. Rogers is very disappointed in you.

I believe Horatio in Hamlet said it best “Now cracks a noble heart. Good night, sweet prince/and flights of angels sing thee to thy rest.”

Or maybe Inigo Montoya when he is advancing on Count Rugen, “Hello, my name is Inigo Montoyo, you killed my father, prepare to die.” Count Rugen pleads for his life in the final duel, offering Inigo all that he wants, money, power jewels anything Inigo wants.

And Inigo, stabbed, bleeding, facing down the man who murdered his father twenty years before, tells him “I want my father back, you son of a bitch.”

Let me tell you, we are all Inigo.

We want our PBS and NPR.

Again, Mr. Rogers is very disappointed in all who voted for this.

North Carolina is going Surgical Smoke FREE

dun-dun-DUN–dun-dun-DUNan–dun-dun-DUN-dun dun

This is the opening guitar riff of Smoke on the Water by Deep Purple. Go to YouTube and check me. You know that I am right.

It was 8 years ago that I recognized that other people, often with less years in the OR, would react to the shall we say unsightly odors of some surgeries. Smells would hit me later in a case than others. A surgeon and a tech would react to the smell of an appendix or open abdomen and it wasn’t until it was closer to me such as when I was collecting the specimen that the smell would make it to my scent receptors, and I would become aware of what they were talking about.

This was a very gradual awareness, brought on by what I assumed was a very gradual over- exposure to the bovie smoke.

Let’s talk about the effects of surgical smoke. It has been compared to smoking 30 unfiltered cigarettes per day. Surgical smoke also contains arsenic, smoke particles, people particles (live tissue fragments), e-coli, SARS-Cov-2 (aka covid), toxic gases, benzene and hydrogen cyanide. It can cause a decreased sense of smell, asthma, allergies, chronic bronchitis, chronic sore throat, and even chronic lung diseases.

Forthwith I became aware that my sense of smell had been altered by 23 years in the operating room. Many of those years were in heavy surgical smoke plume cases- total joints, plastic surgery, and open abdomens.

Surgical smoke is created by use of an electro-cautery device, most often a bovie. This piece of electrical cautery equipment was named after the Dr. William T. Bovie who developed the electrical cautery machine in 1926. This was used to stem the bleeding cause by incisions and surgery.

In 2018, Rhode Island became the first state to enact legislation to ensure that all hospitals and free-standing ambulatory centers used a smoke evacuator in the OR. Many other states joined them- Arizona, Colorado, Connecticut, California, Georgia, Illinois, Kentucky, Louisiana, Missouri, New Jersey, New York, Ohio, Oregon, Minnesota, West Virginia, and Washington.

AND NORTH CAROLINA!!!

We make the 19th state that has elected to protect their nurses, scrub techs, surgeons, and patients.

Smoke free is a misnomer. It is a short hand way of saying that the surgical smoke plume is contained at the site of surgery with smoke evacuation.

However, Governor Josh Stein just signed it into law. To go into effect January 1, 2026.

The hospital system I work for started mandating surgical smoke evacuation during covid. Because, as you may have noticed above, covid is carried by surgical smoke.

Did I write this legislation? No.

However, I have written, and spoke to surgeons, and written legislators, and called legislators, and signed petitions. Basically, we kept up pressure. I even used surgical smoke legislation in the Health Care Policy and Ethics class that I took fall semester 2023. This was when the NC legislature was waffling about it. I did presentations and wrote papers about the dangers of surgical smoke and the importance of going smoke free. I shared the papers and presentations with anyone who asked.

I needed this win today.

Oh, happy day!

School Me Saturday 6/28/25- Students and AI- Part 1

ChatGPT was set forth unto the world like a biblical plague on November 30, 2022.

I was just finishing my first semester of the PhD program when our statistics professor announced it to the class. They said that AI was going to be a big thing for, well, the world. There was not going to be anything that AI couldn’t touch. These programs had the ability to analyze reams and reams of data in a blink.

Less than 3 years later we know better.

Yes, AI is capable of doing amazing things and has vastly sped up the analysis of critical data.

If you know the correct prompt. Or the proper way to word your request.

When it isn’t hallucinating citations and facts that aren’t there.

The pro-AI people say well, that’s because it wasn’t trained well enough. I say that if you put crap in, you get crap out.

My statistics professor also cautioned using the new programs for schoolwork.

Don’t forget, it was released just in time for finals.

Colleges and universities had to scramble to put in rules and explanations of the rules. Some AI is encouraged at some places for some papers for some classes. Some instructors have embraced it and are teaching students about it. Some instructors have not.

It is very confusing.

For me personally, I have only used an AI engine when it was an assignment. I want to be responsible for all that I write, incorrect or not. After all, I was able to survive all of my primary and secondary education without online search. In 1993, Creighton had just put all of their books into a computerized card catalog. I didn’t write my first paper using facts from the internet until 2015.

Now Google is a verb and AI slop is everywhere. AI slop refers to low quality media, including low quality writing and low quality images. Kind of like AI hallucinating things.

Yes, I am older than Google. Hell, I am older than the internet. What a time to be a student! The rules are made up anyway.

One thing that is a bit comforting is that AI is not subject to copy right. Because a copy right means that it was human made and AI is not human.

FFS Friday 6/20/25- Fed, fussy feline

This is a change from my normal FFS Friday content and is brought to you because I wanted to.

Also my husband suggested it. After suggesting the four horsemen of the apocalypse, War, Death, Famine, Pollution and Pestilence, all of which were well represented this past week in the past week, we had to stop talking because the cat was SCREAMING at me to get my attention. He laughed and said I needed to write about her.

This is a FFS Friday on the lighter side. I believe we all need something on the lighter side today in the midst of all the chaos.

You can’t tell me that cats do not have a rudimentary grasp of time.

Ask me how I know? Dot knows roughly when I am due back from work. Dot knows roughly when the spare human is due back from work and also when he goes to work.

Before the other cat died last summer, Dot would wake me to make sure the other cat got fed at 0800. Even if I had just gotten to bed at 0700. Dot is free fed, which means there is always dry cat food in her dish.

Conversations I have with my cat every day include.

Yes, you’ve been fed.

Yes, I will touch your food.

No, I will not top off your dish. You get food added at 0800 and 2000.

No, you cannot have your wet cat food. You don’t get that at 1000 and 1600, you know that.

Cats also have a grasp on simple mathematics.

Dot, despite not having any sweet receptors on her tongue, long ago developed a taste for mini marshmallows. She knows I keep a bag in my desk for her. She knows that she gets TWO at 2000. I fear for my safety if I only have 1 to give her. Not really, but she will plant herself in front of the monitor and STARE until I give her the second one. Even if that means I have to go downstairs to the kitchen and pull out another bag. And if we are ever out of them? She pouts.

Did you know that it is possible to be too touched out by a cat? Again, ask me how I know.

Dot has to be within arms reach of me at all times. We’ve compromised to where she will sleep in her window perch if I am reading on the couch. If I get up to come upstairs to the computer she follows me. If she wants my attention she yells at me. If I am on a zoom meeting she wants in. In fact, I warn people that they will see a white cat, her name is Dot and she has zero Zoom or Teams manners.

If I am called in she is waiting for me, her little head visible in the sidelight, when I pull in.

She absolutely HATES thunder and will hide under the bed. Fireworks are somehow okay though.

Her latest cute-ism is demanding to be lifted to the lip of the bath where one of her water cups is while I am brushing my teeth. You know, so she can keep an eye on me while I am brushing.

She has perfected sitting between me and the keyboard but I can still reach the keyboard and type.

She’s perfect the way she is.

This is a PSA that most of the US will be under a heat dome Saturday-Wednesday. Maybe put out some water for outside animals to drink. Maybe provide shelter/shade if you can.

It’s gonna be hot, damned hot.

Yes, that is an Airplane! reference.

School Me Saturday 5/31/25- Personal school dispatch

Well, I’ve not done one of these for a while now. In fact, I can’t remember the last one I did. And I find that is completely normal. After all, the not so stated plan for a PhD program is to remake you. It just might take a little longer.

In the beginning I was so energized and full of zeal to learn. What a difference three years makes. I am still energized about learning. I am still zealed (?!?) to learn about research.

Here comes the big but.

If I followed my learning timeline of what classes and when I was supposed to graduate at the beginning of May 2025.

Spoiler alert, I did not graduate in May 2025.

All of the core classes are completed. My pilot study has been completed. I even presented a poster based on the pilot study in April at the AORN convention and I am slated to present virtually at the hospital system research symposium in the beginning of June. I am also responsible for a virtual symposium presentation in November.

Yes, all based on the same research from the pilot. The last two are podium presentations where I have to actually talk to people. Maybe there will be a podium, if not I will pretend.

All of these different presentations, the poster and the podiums, is known as dissemination. Getting the information that I’ve worked very hard on for over a year out to the public. Well, other healthcare professionals.

Instead I had the most challenging health year of my life. Getting older is not for sissies. Midlife crap threw me for a loop. We don’t talk about that enough as women and I am so excited that perimenopause and menopause talk has entered the conversation in the mainstream. Perimenopause can cause a host of problems and I had most of them. Cutting to the quick of it, it certainly made my life hell in the last year and certainly knocked me for a loop. But that is a blog post for another time. And not the core reason my school plans got knocked a little awry.

That not so lovely reason is the 2024 election.

And the crap fall out from that.

Suddenly research was under even more stress, if not outright attacks from the people who find it more profitable to pretend not believe in it.

And then the attacks on the institutions who have massively contributed to our modern way of life through their research began.

Every day it felt like there was another strike.

And another.

I felt as if I had to bear witness to it all because someone has to be paying attention.

It was exhausting. Kind of like never ending bullshit torture akin to what I think being waterboarded feels like. Except it is shit decisions that have set the research community back many years. So many years.

All I could do was hold on and not give into the numbness that this crap is supposed to engender in people. Because that is their endgame.

I felt like we were thigh deep slogging through shit.

And then something flipped the mental switch.

I went from mad at the situation and the relentless attacks on research, on institutions to mad that they were making me doubt my path.

So what if research is a skeleton of what it used to be? I will be part of the resistance.

So what it publication is under attack and will no longer be the same. I will continue to write these dispatches.

So what if teaching jobs and professorships and colleges and programs and universities are retrenching their program offerings and job listings. I will continue to teach as I have, in small settings like the Call Bootcamp I run for new to the hospital nurses.

Because we are at war.

This is the “watch me” mad that fueled much of my other academic endeavors.

They think that they can make me stop? Through their pretend shock and awe campaign against the American people and institutions? Though unending waves of nonsense and threats and more threats?

It was a bad idea to make me mad to the “watch me” level.

Watch me resist this crap. Because I believe in science. I believe in research. I believe that colleges and universities. I believe in love. I believe that people have to right to own who they are. I believe in LGBTQIA+ rights. I believe that people have the right to read whatever they want to read, to watch whatever they want to watch. I believe that people are not pawns for the establishment.

You want me to fail because I am older? You want me to fail because I am a woman and that makes little men feel bad?

Fuck that.

Watch me succeed.

Post-it Sunday medical non-fiction series 5/25/25- When Breath Becomes Air

This was another book I read pre-BSN. I was a working nurse and had been for 13 and a half years When Breath Becomes Air by Paul Karanthi was published January 12, 2016.

Admittedly this was mid-BSN course work but I just had to read it. I love neurosurgeon medical non-fiction, I always have. From the first one I read in 1997- When the Air Hits Your Brain: Tales from Neurosurgery by Frank Vertosick Jr., MD. This goes along with the ditty that I learned in nursing school- when the air hits your brain you are never the same.

This is the story of a neurosurgeon resident before and after he is diagnosed with lung cancer in the final years of his training.

Neurosurgeon training is a loooonnnnggggg haul. The google results vary. Some call it 15 years after high school (includes a bachelors of some sort and medical school, internship and residency) and other programs clock it at 7 years (which is minus the bachelors years). In a simpler format, it is seven years after the undergraduate degree and the medical degree. Of course, type-A personalities that 100% of them are, there may be additional fellowship after the end of residency.

In short, you have to REALLY like cutting into people’s heads.

Or the aforementioned type-A personality.

Or just want to care for people who are sick and have no where else to turn.

Sit down.

I’m going to hold your hands and gently explain that I didn’t enjoy this book.

Like, at all.

Take your fingers off your pearls. It isn’t personal.

I get that Dr. Paul Kalanithi wrote this while he was actively fighting lung cancer and actively dying. And that his wife, Dr. Lucy Kalanithi wrote the final chapter explaining his death.

I understand.

I just don’t think it is that great a book.

Seriously.

I re-read it this past week to make sure that I still felt that way. Also I re-read it with the knowledge that I had finished two whole nursing degrees and am most of the way through the third in the intervening years.

There are entire passages of brilliance. I marked 11 pages of them.

This book is this man’s journey to coming to grips with a fatal disease. I can understand that.

I can also appreciate how they let his voice drive most of the way through the book. It starts off strong when he was a boy and stronger when he is in medical school, before petering out over the course of his illness. If this was intentional this is masterful editing. If this is not, it is still masterful storytelling.

My biggest pet peeve with this book is that it is over-confident in its own brilliance and the author is a huge name dropper. Granted most of the names dropped were author’s names but nurses were not named. Not once. His surgical nurses were only mentioned a handful of times, including the conversation about his long hours at the hospital that apparently the nurse didn’t understand? I bet she did. Oh, and they were always women, nameless women who didn’t understand the pressures on a rising neurosurgeon resident. My feminist heart didn’t like this one bit.

I appreciated how he let his patient’s be fully realized people in his mind. I find that is the best way to approach a patient. As if they are people too, not just a problem for him to do surgery on. This I liked.

But I kept thinking how one note the nurses were. In fact the only named women are his co-resident, his wife, and his oncologist. Otherwise they were referred to as the relation to him and his wife and his family. No, thank you.

I stand by my first impression of the book as a memoir of residency. That there were better instances out there. Even as a memoir of his death I give it an 8/10.

Would I read it again? Yes, and I have.

Would I shelve it on my bookshelves? Yes, and I have.

Would I recommend it? Yes, as a book on dying.

Tuesday Top of Mind 5/13/25- Fluoride and why getting rid of it is a bad idea

There are a lot of dumb hills to pitch a fit over these days. My least favorite is the anti-fluoride movement.

Fluoride is important because it prevents cavities and strengthens teeth. As someone who has a complicated relationship to my dentist I am in favor of everything and anything that decreases my chances of additional tooth decay.

Fluoride has been shown in some shoddily done studies to “alter your gut microbiome and has suggested associations with thyroid disorders, weight gain and possibly decreased IQ”.

Note the important shoddily done study in question that indicates decreased IQ has been roundly criticized and recommended for retraction. Yes, it is that bad.

The measurements used to ascertain IQ decrease were 1) not validated, 2) used different testers, 3) done in multiple cities. It is the first point that is the most crucial. I can swear to you that the sky is pink, not blue. I can have other swear the same to you. But I won’t let you look at it to see for yourself that it is pink.

It is the same energy as the question that captivated the internet in 2015, is the dress blue or gold.

Bitch please, it depends on the lighting. True, sometimes the sky is pink, especially in the early morning as the sun is rising, or later in the day as it is setting.

For a sarcastic example: Yay, you proved that the sky was pink at 0635! Now prove it again and again and again. Also, prove it at noon.

I’ll wait.

Who are you going to believe? Me, or your lying eyes?

Ugh.

Nothing that the troglodytes and mouth breathers have brought up, none of the studies have been replicable. That means no one else has been able to do the same study, as outlined in the study, and gotten the same results. This is the major finding. This is the flaw in the study.

Trust me, I’ve taken many graduate level courses to make sure that the studies that I will create are able to be replicated. This is why what these people who are playing with fire drive me so insane with anger. They don’t know enough not to touch the hot stove. But they will blame the resulting burn on vaccines, don’t worry.

This is more bluster and nonsense coming from non-science believers.

There is a big story going around now that the Secretary that is pushing for this swam in feces contaminated water. Worse, he let his grandchildren swim in the same water. Gross.

Also, double ugh.

As someone who has spent thousands of dollars at the dentist in the last year, I will keep my fluoride toothpaste and my fluoridated water. Or is someone going to tell me that the hole in our bank account is a figment of my imagination or the pain that I’ve suffered through is in my head or is because I am overweight?

Triple ugh.