About This Blog

About Me

I am a former United States Marine Infantryman, a structural engineer in a previous career, and currently an Emergency Medicine Attending Physician.

I will try to answer any questions except the ones that stump me. (”What do you think about Neuro-interventional Radiology?” for example, one of many subjects on which I have no legitimate opinion.)


Welcome to my blog. Your comments are appreciated but please, no pointless ad hominem attacks. I don’t go to your house and yell at you, why would you do it at my house? Because the internet makes you anonymous? Please. We have gone way beyond the kind of idiocy when, back in the early days, everybody was a troll because there just wasn’t that much going on.

Today, you can find a thousand web sites that exactly mirror whatever opinions you hold dear so there is no need to get your panties in a wad. If you’ve got something to say, just say it. If all you want to do is vent then vent but don’t expect me to take you seriously…and I’ll delete any overtly insulting comment unless it makes a good point. Same with bad language. I’ll allow it where appropriate but be creative. You also have my pledge that I will never delete a comment simply because I disagree with you.

In short, be as caustic and critical as you like but try not to be a cretin, all right?

A word on politics. I am extremely conservative politically. Some of you are not. The great thing about medicine is that a lot of it transcends politics. Left or right, we can all get irate about the insulting wages of residents or the torture we inflict on the terminally ill (two themes you will see repeated on my blog).

I am interested in your political point of view as it relates to medicine but this is not a political blog and, as I am still post-ictal from the 2004 presidential election, I will delete any toxic spew of the type that passes for political debate on much of the web.

For International Readers

I’m always happy to hear how they do things in your country. I’m sure a lot of our system of medical school admissions and residency training seems strange to many of you so if you have any questions, feel free to email me.


To protect their privacy, the names, races, ages, and distinguishing features of all patients mentioned have been changed. Some patients are composites but not as many as you would think. The usual constellation of comorbidities which you will notice a lot of on my patients are distressingly common and, for example, relating that Mr. Smith

had Coronary artery disease, Peripheral Vascular Disease, Heart Failure, Emphysema, Obesity, Diabetes, and Obstructive Sleep Apnea would probably not help anybody in discovering his real identity. Half of the people I see have most of those and more.

The same with ICU patients where it seems every other bed imprisons a completely demented, immobile, elderly, and barely functioning zombie. Sometimes the nurses page me about the 84-year-old lady with the decubitus ulcers eating down to her bones, the advanced senile dementia, and the recent history of a massive CVA and urosepsis to which I usually say, “Uh, can you be more specific?”

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Read at Your Own Risk

Medicine is not a cult. It’s a job. I pretty interesting one and I enjoy it for the most part but there are aspects of it that are less than savory, particularly a lot of what passes for normal in residency training. Take what you want out of my blog. If it distresses and vexes you to hear blasphemy then, while I appreciate your interest, why you’d want to inflict this blog on yourself is beyond me. I’m not trying to talk anybody into or out of a career in medicine and this decision is entirely yours. You can find plenty of medical blogs which are information organs for The Man if that’s what you really want.

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