Super Bowl Sunday!

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by Insurance Guru

I admit it, I love football. I grew up with a Dad that loved to watch and taught me the rules. The future ex-Mr. Guru is a huge fan and by default so is my son. Is there anything as exciting or more American than Super Bowl Sunday!? I can hear the NFL Films music right now and the voice of John Facenda... "the frozen tundra of Lambeau Field...".

I also love an underdog, Cinderella story so I am extra excited to see the long suffering Arizona Cardinals in the mix. Sorry, Steelers - I'm not rooting for you this year.

So come on over, the Guru is having a Super Bowl party. Bring some dip and pull up a chair. The big screen will be running in high definition, the TV in the garage will be available for the smoking section, if you need a moment to yourself, the office and guest room TV's will be warmed up. Fair warning though, the Guru will skip Springsteen at half-time and we WILL be watching Puppy Bowl V on animal Planet.

Go Cards!

Behind the Velvet Rope

by Insurance Guru

I sure did have some kind of hissy fit during my efforts to get a referral to have my knee looked at before my leg fell off. However, now I feel as though I've been let behind that red velvet rope that keeps the unwashed masses away from the famous folk in L.A. clubs.

The Orthopedics office was quite posh and took up the entire floor of a medical complex. On my first visit I had my knee x-rayed a hundred different ways and within 30 minutes, I was talking with the doctor about the results. He decided I needed an MRI and their crack office staff would make all the insurance arrangements and... THEY DID! Who knew such a thing existed?

I was able to have the MRI at their offices and it was such a cute little machine. It was built just for lower extremities, so no freezing in a gown trying to keep still while your nose itches. Within a few weeks we had the results and it looks like the Guru will finally get that annoying meniscus tear fixed. The crack office staff promised to take care of all of those arrangements, too... but it's been a month now..... (sigh)

Ghost Tour

Buck Bannister found an amazing discussion thread at allnurses.com. This thread titled, "What's Your Best Nursing Ghost Story?", has been going strong from June 2005 to the present! You have got to check it out. The stories are absolutely addictive.
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The LAist has a good, creepy story "Weird Los Angeles: The Curious Cavorting Coffin". Believable? No. But a good story nonetheless and an excellent example of "urban legend as cautionary tale".
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Forgetomori explores one of the most talked about, "recent", paranormal photos. The Wem Town Hall Ghost was photographed in 1995 by Tony O'Rahilly and after some scrutiny, has arguably been thought to be the real deal.



This two-part documentary does an excellent job investigating both the town hall fire and the photograph.



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Veatrice Rice 1949-2009

Veatrice Rice from "The Jimmy Kimmel Show" died from cancer on January 21, 2009. The following clip is Kimmel's tribute to this poker-faced, funny and foul-mouthed woman. Warning: Some bad words ahead...

Back From the Abyss

by Insurance Guru

Whew, what a grueling couple of months this has been. Deep in the Cube Farms on Insurance Island, we have been slaving away to get the 2009 Benefit Plans loaded, the 2009 Medicare rules, rates and insanities loaded, the 2009 contracts up and running and still hoping that claims don't blow up at the other end.

Insurance Cube Farmers rarely have a long Christmas or New Year's holiday. I myself worked straight through all the holidays and even through a couple of scheduled PTO days. It wasn't the best time to be told there are no raises this year and no assurances regarding future down-sizing.

However, a plane landed on the Hudson River and all survived, the Arizona Cardinals are going to the Super Bowl and a Black American is now the president of the United States. Has someone sent scarves and mittens to hell? This might just be my kind of year!

Articles of Interest

The recently ailing Christian Sinclair of Pallimed pays an "office visit" to his inner Dr. Sinclair in his post, "Sometimes Being Sick Helps".
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Australian nurse, Peter McCartney, asks the question "Do Nurses Make The Worst Patients?". Personally, I've found the vast majority of nurses to be excellent patients, but Peter has thrown my opinion off a bit.
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Jessica Knapp of The Good Death discusses the recent death of a six year old boy at a monster truck rally in Tacoma. Sadly, the websites for area newspapers have sparked some comments that could only be produced under the anonymity of the internet.
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Naturally, the Mencken quote at the beginning of this post immediately caught my eye..."A cynic is a man who, when he smells flowers, looks around for a coffin."
Tricia, of Papercages, packs a punch as she defends her right to be inspired by our new President.
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My dear, blog-buddy, Buck Bannister (yeah, that's alliteration) exposes the shameful state of emergency, next-of-kin notification for LGBT spouses. Of course, the ramifications of this go far beyond not being notified if your spouse is in an accident. Please check out his excellent blog, Southeast to Southwest.
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Welcome, President Obama!

Inauguration Speech

Visit msnbc.com for Breaking News, World News, and News about the Economy

Happy Martin Luther King Day!

Dr. King: Segregation on buses in Montgomery

A Talk With a Doc II

1945 hrs -- Hospice consult in hospital emergency room (New Year's Eve)

Telephone Conversation

"I see from your orders that you want Mrs S. to be admitted into an inpatient hospice unit. She just doesn't qualify for that right now..."

"WHY NOT, WHY NOT, WHY NOT!?!!"

My God, he's screaming... I hold the phone out at arm's length. He's caught me completely by surprise. It's been a very long time since I've been on the receiving end of an MD's temper tantrum.

"Well, Mrs. S. just doesn't fit any of the criteria for admission. There are no symptoms to manage. She... "

"THAT'S NOT AN ANSWER! Give me an ANSWER! Why? WHY?!"

"Look", I continue, "Mrs. S. is stable. Her vital signs are good. No more respiratory distress, her O2 sats and vital signs are fine, she's coherent and in no pain whatsoever. There's no reason for her to be admitted into the unit." (What's wrong with me? Why am I allowing his abusive behavior to continue?) I forge on ahead... "With her history of COPD, I'm sure she's appropriate to receive our services in her home. Just discharge her home and we can sign her up tomorrow."

"What does her family have to say?"

"There's no family with her right now", I reply.

"Well, of COURSE NOT! They're gone because they think she's going into a hospice bed. They can't take care of her anymore. Isn't THAT a reason for hospice admission?"

A not so pretty picture is coming together in my head... The family is out partying like rock stars right now on New Year's Eve because Dr. E. told them that she's going to live in a hospice until she dies. Great.

"Actually, Dr. E., my supervisors have told me that that hasn't been an acceptable reason for admission for over a year now. Listen, she's a Medicare patient, if you're so determined to have her go inpatient, you can try calling any other hospice in the city and have them come give her a look!"

"She's NOT Medicare, she's got "Senior Perks" coverage and only YOUR hospice can TAKE her!!"

Okay... I've had enough. Reaching deep within, I manage to find the tiny, "Testicle of Intestinal Fortitude". Clutching the little guy within my sweaty palm I say:

"Dr. E., it's common knowledge that anyone that has Senior Perks insurance also has Medicare coverage. But I imagine that it's so much easier to be abusive than informed, isn't it? This conversation is over and I'm giving the phone back to the Charge Nurse."

I hand the phone over to the RN. As I write a progress note detailing why the patient is not suitable for inpatient admission, I notice that the Charge Nurse is writing an order for another hospice to come in and evaluate the patient. Ah... the next hapless victim. I hope that they're able to find their "Testicle of Intestinal Fortitude" a lot faster than I did.


Click here to get the Joint Commission's take on bullying in the workplace.

Superstition

I was on duty last night. Not only did I not have to leave my house, but I didn't even get so much as a single hospice-related phone call! I even called my company-issue "Zoolander phone" to make sure that the tiny, little piece of plastic was still functioning. It was.

Zoolander phone... for people that can't talk good.

Yeesh... the karmic bottleneck must be of apocalyptic proportion! I am so not looking forward to the rest of my work "week".

Oh, and please don't wish me a "quiet night". Use of the "Q word" is guaranteed to send me into spasms of superstitiousness.

Counting My Blessings

I've just come back from an emergency, mandatory meeting at the hospice office. There will be no pay increases for any staff members this year. My poor boss was nearly beside herself... dreading the potentially hostile reactions from the hospice staff.

After her announcement, no one even blinked. When she assured everyone that no layoffs would occur, the staff collectively relaxed and began expressing gratitude at keeping their beloved jobs during these difficult times.

As I was leaving the conference room I heard someone say, "I think we should have a party!". Yes, I would agree.

Your Moment of Awwwww...

Puzzled Puggies

The Funereal Buffet at Dethmama Manor

Mmmm... wish everyone could be here. Company's coming and today's late, Sunday afternoon meal is Oxtail alla Vaccinara... a sweet, sweet recipe from Mario Baltali.
Very rich. It's really only meant to be prepared and served during the winter. If you want to partake, just ask for the recipe at dethmama dot gmail dot com. It's truly a fitting addition to the Funereal Buffet.

My multiple chins and love-handles will vouch for it!!

Articles of Interest

In The Good Death, Jessica Knapp tells us the story of her mother's eerie, email experience.
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Dr. Amber Wollesen, at Pallimed: Arts & Humanities, shows us a palliative aspect from the TV show, Scrubs. The "Bad News Robot" is a must-see!
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Think the health-care professions are recession proof? I think you should take a look at DisappearingJohn RN and definitely read the comments to his post.
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Maurice Berstein, MD explores the ethical issues faced by healthcare providers that must see and treat the "frequent flyers".
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Leo Levy presents us with a great four-part story called "My Code". Click here to read part one... after that you're on your own.

The Photo Op

Image via Wikipedia
2315 hrs.

"How's this one?" I ask, cocking an eyebrow in her direction.

"Yeah, well no... you've got to get in a lot closer," advises Mrs. J., "Let's try again."

I figured she'd say that. It's not quite what I wanted to hear, but this camera phone is awful. I've already taken three pictures and so far, none were to her liking. Mrs. J. lies down again by her husband, positions his face cheek-to-cheek with hers and she smiles. I bring the cell phone in much closer and get another shot.

"Okay, better?"

"Oh, tons", she replies. "Can we do one or two more like that?"

"Sure."

The patient's wife resumes her position and as I lean forward to take the picture, a stream of green-black secretions oozes from the dead man's mouth; just missing his wife's hand. Mrs. J. simultaneously drops her husband's head and bolts from the bed.

"What the f*@k was THAT!?!"

"I think we'll call that a wrap, Mrs. J."


For information on post-mortem photography click here and here.

Your Moment of Awwwww...

The Puggy Thief