Monday, 19 May 2014

07:50 – I learned something from a front-page article in the paper this morning. I’d assumed that North Carolina had a modern medical examiner system. Not so, as it turns out. We have what are called medical examiners, but in fact the setup is more like the old, obsolete coroner system. Medical examiners are appointed by the state medical examiner, and there are no qualifications required. We apparently have nurses, paramedics, and morticians working as medical examiners. And, incredibly, they’re paid piecework, a flat $100 per body. They don’t even get mileage for visiting the scenes, so they usually don’t. In one of the cases described, the medical examiner ruled the cause of death a car accident. Fortunately, the funeral home noticed four stab wounds in the guy’s back. The medical examiner said she’d looked at the guy’s body at the morgue, but hadn’t bothered to turn it over. Quincy wept.


10:39 – We have a contractor doing some work today. They showed up around 8:30 and got to work replacing the columns on the front porch, which were rotting. They installed aluminum replacements. That took a couple hours. Now they’re chiseling out the rotting threshold of the back door, replacing it, and replacing the storm door out to the deck. Barbara’s been wanting to do these projects for a while now, so I’m sure she’ll be happy when she gets home and sees that they’re complete. Colin is not happy about what’s going on, though. I have him penned up to make sure he can’t help with the projects.

39 thoughts on “Monday, 19 May 2014”

  1. Some while ago, Slashdot pissed off a fair portion of their users, who migrated to a new site SoylentNews. Where this is now a story posted about the Heirloom Chemistry set.

    In the comments, I posted a link to our hosts website, where he sells his science kits. To be sure I had the right place, I paid it a visit.

    @RBT: I really think it would be worth your while to pay a web designer to put together a better web site. I’m someone who doesn’t worry much about appearance, so if it looks slapdash to me, then there’s room for a lot of improvement.

  2. Thanks.

    I haven’t bothered to hire a web site designer, because one of the things on my to-do list is to migrate the site to an e-commerce package like Zen Cart.

  3. Re: the NC Medical Examiner system

    It’s frontier law that held on to today, much like common-law marriage. I’d imagine there are a few counties in Texas where there is no MD medical examiner, since there are no MDs in the county. And I’d bet that few of the medical examiners are pathologists outside of counties with mid sized cities. I know that the Harris County medical examiner does autopsies for quite a few of the counties in SE Texas.

  4. I hadn’t thought about it before. If I had, I’d have assumed that North Carolina had a regional medical examiner system, with some or all large cities/counties having their own, which also served surrounding counties. I’d have assumed that all staff who held the title “medical examiner” were board-certified pathologists, with at least some certified forensic pathologists, albeit the latter perhaps only at the state level.

    What this really means is that it’d be pretty easy for a smart person to get away with murder in North Carolina. I actually should have twigged to this earlier. Although female serial killers are relatively rare, North Carolina had not one but two that were caught back in the 80’s. I forget whether it was Velma Barfield or Blanche Taylor Moore who was finally caught because a nurse–a NURSE–pointed out to doctors that the symptoms of a patient might be caused by arsenic poisoning.

    Arsenic is among the easiest of poisons to detect, but of course one has to look if one is to find it. Obviously, no one had looked at these women’s earlier victims.

  5. I forget whether it was Velma Barfield or Blanche Taylor Moore who was finally caught because a nurse–a NURSE–pointed out to doctors that the symptoms of a patient might be caused by arsenic poisoning.

    I have some nurse friends who will tell you that half of their job is preventing doctors from making stupid mistakes. Of course, most nurses also suffer from martyr syndrome and have a very high opinion of themselves. In their minds, the world would screech to a halt but for nurses. I’m sure plenty of doctors have corrected/prevented nurse mistakes too. They just don’t feel the need to get a public pat on the back for it.

    I’ve asserted for years that women do all of the same bad things that are typically associated with men (infidelity, serial murder, etc.) They’re just MUCH better at not getting caught.

  6. Sure, an experienced nurse is to an inexperienced doctor as a platoon sergeant is to a green second lieutenant. And, in all fairness to the doctors in question, arsenic poisoning closely mimics gastroenteritis and arsenic is no longer readily available as it once was. Still, I’m not really criticizing the doctors who were treating that patient. I’m criticizing the medical examiners who didn’t even think to test earlier victims for arsenic. Granted, there’s no such thing as a tricorder, and they’d have had to look, but in the case of suspicious death with no obvious cause, I’d think that a comprehensive tox screen would have been the first thing they did.

  7. They’re working on a tricorder. True, it’ll have to touch the patient and draw fluids, but automated devices for diagnosing disorders are coming.

    They’re likely to face opposition from the medical business. More than 20 years ago, one of the things I worked on was an expert system for medical diagnosis based on both subjective symptoms and objective measurements. (This was long enough ago that PROLOG was the hot language for such things.) The patient, possibly with aid of a nurse for getting measurements, could use it, without needing a doc. We were getting pretty good, up around the accuracy rate of an experienced clinic doc and with lots more rules to enter and improvements to make, when the bottom fell out. This “device” wasn’t going to get approval for use. This wasn’t a matter of needing to tweak something or paying for clinical trials; it never would get approval for use. I don’t recall any official reason being given, but we speculated that the AMA didn’t want to put their boys out of business, so they yanked the FDA’s chain.

    (I was working on this startup while working a full-time day job and going to school 3/4 time for a MS and trying to keep up a social life. A couple people mentioned that I seemed stressed and irritable all the time and bedmates noticed that I barely slept. Go figure.)

  8. (This was long enough ago that PROLOG was the hot language for such things.)

    I recently attended a lecture series by a guy doing research in this area. Among other things, he made the automated online diagnosis system that the NHS uses. He said that PROLOG is still pretty popular for some of this stuff, especially in research.

  9. I learned something from a front-page article in the paper this morning…

    What’s a paper? 🙂

  10. It’s something that Barbara subscribes to because she is a Winston-Salem native and wants to keep track of who died.

  11. Haha, as we get older, some of us get pretty good at that (tracking who died). Shadenfreude when someone younger buys the farm. Jealousy when somebody 105 finally kicks it but was in perfect health from smoking cigars and swigging brandy his or her whole life and checked out while splitting firewood during a blizzard after a tree fell on them and then no one came until it was too late.

    Here is our famous “death investigator” for Vermont, and his Joe Gunther series is pretty dahn good, too:

    https://en.wikipedia.org/wiki/Archer_Mayor

    Just back from VA Med Center; BP meds reinstated; same inhaler deal for asthmatic wheezing; tough shit for back (it may heal itself, nothing they do is gonna make it go any faster or easier and pills are useless); and probably gonna work with other combat vets down the road a bit in the near future, in regard to PTSD issues. Should be a barrel of laffs. But better us than pretty much anyone else.

    Gorgeous day for four hours of motoring happily down and back up the interstate. Wife’s Saab convertible blew them all off and didn’t have to break 100-MPH more than once or twice. (no fool like an old fool, ain’t dat how it goes?)

  12. Just back from VA Med Center

    Why are you still kicking Mr. OFD? I thought Obummer’s VA would have tried to bump you off by now. Since you didn’t have to wait in line like the poor deceased vets waiting for months, I’m guessing there will be a little something extra in your meds.

    Holder on State ID for voting: “Fuck you, the gummit is suing you cause RAAACIST!”

    Holder on VA fuckups: “Fuck you, it’s your State’s problem, fix it!”

    The entire military force of the US should refuse to come to “work” for a month to send a big “fuck you” to Holder, Obuttwad, Congress, etc. for the disgrace that they’ve let the VA become.

  13. The entire military force of the US should refuse to come to “work” for a month

    Strangely enough, contracts or other commitments to the government don’t end when the government breaks their side of the deal. You’d think that a contract which was not evenly enforced was no contract at all, but when the side breaking the contract also controls the courts, this turns out not to be the case.

  14. What SteveF just said; any contracts with Leviathan are Leviathan’s to abide by or not and fuck you very much. Works sorta like the banksters and insurance weasels; if it’s in your favor, tough shit, it will take forever or not at all and don’t by Gawd complain or you’ll NEVER see it. If it’s in their favor they come after you with hammer and tongs and then your firstborn.

    I hear horror stories about other VA med centers around the country but the one up here has always treated me like royalty. And I see how they treat everyone else the same way, too. From janitors on up to the Director and everyone in between, total, unqualified respect. I have zero complaints about them, zero.

    Forgot to mention the second, requested, chest x-ray; an “abnormality” was observed last fall on the upper thoracic spine area and they are looking at that now. No idea what that means and not worried. Fuck it, it don’t mean a thing. If it ain’t got dat swing.

    On the entire military force out there? Dunno about them not coming to work, but that probably wouldn’t happen for a quite a while yet, when the money finally runs out to pay them. Meanwhile it’s an interesting question sometimes posed on other sites as to whether or not the troops would shoot fellow citizens, and I think we have the results in on that one as we scan the ol’ Murkan history books, going back, say, to just after the War of Independence. The real question is would a balance-tipping force of citizens shoot back? Yeah, I know an AR and a Kel-Tec ain’t gonna do well against an Apache gunship or F-35’s and tanks. But people have to drive those machines and those people also have to eat, sleep and crap somewhere. And get to and from the machines. And have families back home.

  15. Chuck, what is it with music on CD’s today? All the tracks are maxed out to the point of 50% of the track is clipped. I thought making music loud was the function of the amplifiers and not the D-A converters. Once digital clips the sound is horribly distorted. Are the audio engineers of today that clueless? Or are they just audio idiots?

  16. Obummer’s press secretary on the VA scandal:

    “Obuttwad heard about it on the news.”

    I didn’t think there would be a worse CINC than BJ Clinton, but Obummer’s has him beat by a mile. How could he not know this?

  17. I love how he feigns rage at this stuff; neither he nor the previous Larry Klinton regime give a blind rat’s syphilitic ass for veterans or active duty military, for that matter. At least the two Bush regimes could put on a good act; one was a Good War combat vet and other a fighter pilot in the TX ANG, though word has it he was mostly a no-show. Still, takes some guts, knowledge and skill to jockey an armed jet around the skies.

    Then, of course, the VA takes a guy who’s about to retire anyway and tell him to resign, while probably giving him a real nice golden parachute.

    This event evidently has some fallout around the country, though; I skipped out on one of my appointments down there today, mainly due to waiting around too long and getting jittery at all them kids rolling in with the 1,000-yard stares, plus the old guys hollering about their bills and suchlike. By “waiting around too long” I mean a half-hour, not months or years, like with some cases. It was a busy day there and I had had enough, after four hours of the other stuff.

    So I get home and there’s a message on the machine; the woman with whom I was supposed to meet called to make sure I was alright and and all apologetic about the wait and so forth. I assured her all was good, not to worry. Had a nice chat and now she can sleep tonight and not worry that President Barry Soetero is gonna come bashing her door down to fire her ass.

  18. One of the reasons I chose the Lifestraw is that there’s nothing mechanical to break. Another was its rated capacity of 2,000 liters. I don’t see the capacity of that pump specified anywhere on Amazon.

    Anyway, the Lifestraw is just a backup. My first choice is to boil water whenever possible.

  19. It’s something that Barbara subscribes to because she is a Winston-Salem native and wants to keep track of who died.

    What is with the female obsession with obituaries?

  20. That’s interesting. I’ll have to check the package, but I’m pretty sure it said 2,000 liters.

    Not that it really matters much. These are in our car kits, which are designed to support two people and one dog for three days. Even in warm weather, we’d need only five liters per day of drinking water for the three of us. At 1,000 liters capacity, that’d be 200 days.

    And, again, by preference I’d boil our drinking water, which results in a lot more than a log 6 reduction in bacteria and a log 3 reduction in protists.

  21. If you read Kathy Reichs books about Tempe (Temperence) Brennan you fill find that she makes several comments on the NC “medical examiner” system. I find the books to be good reads and very different from the TV show “Bones” which is also loosely based on the books. Tempe Brennan of the books is very different from the Temperence Brennan of the show.

  22. I always thought that Prolog was verbose. C++ with a side of Fortran rules!

  23. I just read “Going Home: A Novel” (The Survivalist Series) by A. American:
    http://www.amazon.com/Going-Home-Novel-Survivalist-Series/dp/0142181277/

    The author has a prepper dude walking home from Tallahassee to Orlando in Florida after a USA wide EMP event. He uses the SweetWater filter to get drinkable water for him and his companions. He also noted that your water usage goes way up when traveling by foot over 250 miles with a 60 lb backpack. Plus running from roving bands of thirsty and hungry people.

  24. ” Plus running from roving bands of thirsty and hungry people.”

    Why run? Mow the buggers down with a chain gun. RPGs. Streetsweeper shotguns.

    Good to know, though, in case one’s vehicle breaks down or is rendered inoperable by, say, an EMP, one runs outta gas and no gas to be found or gas pumps won’t work, or if vehicle is jacked. Might have to hump a ways on foot, toting a load, including weapons and ammo. Hope you have good boots and spare socks, etc. Kind of a hump, depending on weather and stressor events when one is a strapping 18-year-old; a bit more so when one is 60+ and a little rickety in the joints and also toting what the late Mel Tappan called his cleverly designed ‘portable modular food storage unit” above his belt.

  25. The prepper dude had a Springfield .45 cal XD pistol and a small Taurus revolver. The problem is that other people had guns also and no food. Staying away from large crowds of other people is the name of the game here.

    late Mel Tappan called his cleverly designed ‘portable modular food storage unit” above his belt

    I’ve got one of those also. About 40 or 50 lbs worth. Walking 250 miles in eight weeks with a 60 lb pack would take care of that problem. Of course, I would run out of blood pressure and afib meds in a week or two and just not wake up some morning soon after. Or wake up a drooling idiot after a major stroke.

    I took all my meds with me to Montana last week just in case something weird happened. Since I did, nothing happened. Last Friday I looked at the sunshine and did not take my down vest on the Missouri river. Of course the temperature dropped 20 F with a 20 mph wind and froze my butt two hours later on the skiff. Rain jackets do not cut that wind. If I had taken my down vest then it would have been 70 F all day.

  26. Live and learn, I always say, plus the Boy Scout and Coastie motto: Semper paratus.

    I assumed, and we know what that spells, that the roving bands of starving derps were unarmed or poorly armed; in that case, yeah, stay away from them and pick them off when they get too close, aiming for ringleaders.

  27. Lynn wrote:

    “I always thought that PrologCobol was verbose. C++ with a side of Fortran rules!”

    There, fixed that for you.

  28. For one of my microprocessor classes around 1984, the teacher or the computer department or something never managed to get my account set up, so I had to write my assembly language programs and then manually convert them into hex and then type them via hex keypad into the prototype box. Most of the other students got to use the computer to assemble and then load to the proto box via serial cable. Buh. Don’t want to have to go through that nonsense again. (I got an A in the class, but never knew whether that was objective based on projects or if I got a bump for having to go through the extra BS.)

  29. The very first computer I ever built, back in about 1976, was programmed with toggle switches and jumper wires. It had a massive 256 bytes of memory.

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