Wednesday, August 31, 2005

Mississippi has become a 3rd World Nation

In the aftermath of Katrina, most of Jackson, the capital of Mississippi, remains without power- see this article. Some of the gas stations have gas; some have the power necessary to run the pumps; only a few have both. As described here, lines at the few open gas stations are long. As bad as things are in the capital, it is even worse in outlying areas. Some rural areas in central Mississippi will not get electric power back for several months. As I have mentioned in previous posts, if a Mississippian is lucky enough to find an open store or gas station, he better have cash. Credit cards are not usually accepted- see here.
I feel bad about whining as plenty of people have it worse than me, especially those living to the south of me. But with the destroyed infrastructure, it is becoming increasingly difficult to function as a physician. With the power out, I have no way of doing laundry at home. Today, for the first time, I wore a t-shirt to work instead of a shirt with a collar. I guess I could ask a resident where they keep the scrubs. I run out of underwear and socks on Friday- at that point I will need to wash them in a bucket. Another option is sneaking my laundry into the hospital and using the washer on the psych ward.
I am on call (psychiatry attending call) Thursday. Since phone service is out, I will have to spend the night in the hospital to answer the pages (I am one of the few physicians in the country without a cell phone)
I have decided that tomorrow (Thursday) I will leave the hospital in the early afternoon to get gas. For anyone that is interested, I will post my adventure tomorrow night.
That's it for now. Sorry about the whining. Thanks to Dr. Parker for the plug. Read about the situation in Alabama here. Donate to the American Sleep Medicine Foundation Hurricane Disaster Relief Fund here.

Mississippi Katrina Update

It's a sunny, warm day here in Jackson, MS. The power is still out in most residential areas. Some gas stations are open, but lines are an hour long and it's cash only. ATM machines are down but most banks are reportedly open. My wife is planning to walk to AmSouth bank later on today to get money. I hope power comes back soon, I am running out of things to wear. Large fallen trees still block most of the streets that lead to my house.
The situation is much worse in southern Mississippi, Louisiana, and Alabama as described in this report. Good luck to those of you living on the Gulfcoast.

Tuesday, August 30, 2005

Katrina Report from Ground Zero

Power began to fail at noon yesterday in central Mississippi, and pretty much went out for good at 6pm. Today (tuesday) power is still out in most parts of central Mississippi, though as of noon today a few gas stations and large grocery stores in Jackson had power.
Trees are down all over my neighborhood.
At least 80 people are dead in Mississippi, most in southern parts of the state.
Interstate 20, running east-West between Jackson and Meridian, is basically clear- but make sure you have gas before starting the trip as none of the surrounding gas stations have power.
Here is a report of the condition in Hattiesburg, which is 90 miles south of Jackson, MS.
The University of Mississippi Medical Center is fully operational for clinical care, but nonessential personnel will not return until tomorrow.

Friday, August 26, 2005

Jet Lag

ATLANTA—Already hard hit by labor strife and escalating fuel costs, the commercial airline industry faces a new crisis: an epidemic of jet lag caused by a powerful strain that is highly resistant to regular remedies like catnaps.
Airlines have set up napping-triage centers in major airports in response to the "Super Lag," but are unable to keep up with the rising tide of severely weary passengers, who number in the thousands nationwide.
"Infected travelers are really tired out, whether they're on long international flights or domestic flights as short as an hour and a half," said Delta Airlines ticket agent Olivia Gage at Atlanta International Airport, which has seen some of the most advanced cases of Super Lag. "Our supplies of thin blankets and miniature pillows are running dangerously low."
FEMA, the Federal Exhaustion Management Association, has shipped army-surplus cots and urns of hot coffee to several major hubs, but airlines continue to report record dozings. Minneapolis resident Belinda Haynes, 26, is just one of tens of thousands of Americans whose travel plans are affected.
"I'm going to go to Tampa Bay and be asleep through most of my flight," Haynes said. "That means I'm at risk for catching Super Lag and being totally tired all through my sister's whole wedding."
At the Atlanta airport Tuesday afternoon, an estimated 900 Super Lag sufferers could be seen stretched across the molded seats of gate waiting areas. The infected travelers, distinguishable by their testy demeanors and heavy eyelids, argued with ticket agents, slumped listlessly in their seats, and stared blankly at Au Bon Pain pastry displays.
Untreated victims can find themselves sleeping for hours on a plane, then sleeping soundly at night, yet still performing poorly in important business meetings or feeling too fatigued to enjoy their vacations.
Dr. Robert Sanders is one of hundreds of volunteer physicians treating Super Lag sufferers at airports nationwide.
"Jet lag was first documented in the late '50s," Sanders said. "Over the years, we've developed band-aid solutions to combat the disorder—neck pillows, laptops, in-flight movies—but it was really only a matter of time before jet lag mutated into a more virulent strain."
Despite volunteer efforts, the burden of treating Super Lag sufferers has fallen largely on flight attendants who, with little training in this area, are reporting great difficulties.
"One passenger who sleeps through the beverage service and wakes up irritated and thirsty is bad," said Midwest Airlines flight attendant Sandy Wolchek. "You multiply that by five on a Milwaukee-to-Minneapolis flight, and you're talking about a serious disruption."
Prolonged rest is the only known remedy for Super Lag, according to Bill Ziegler of the Centers For Fatigue Control. "Victims can also alleviate their symptoms by wadding jackets or sweaters into makeshift pillows," he said. "And we're recommending that airlines loosen their restriction on reclining cabin seats during the ascent and descent phases of flights."
Scientists at the CFC are working around the clock to find a Super Lag cure, but so far, they have made little progress. For now, they recommend that air-travel passengers look out for Super Lag's warning signs: irritability, an unwillingness to engage in small talk with persons in adjoining seats, and a tendency to doze off while reading in-flight magazines.

From The Onion

Monday, August 22, 2005

Weight Loss Secrets

PURCHASE, NY—Joining a field already crowded with such non-caloric beverages as Coke Steam and Hollo Yello, PepsiCo announced the creation Monday of Pepsi Negative-220, a diet cola that burns twice the calories it contains. "You'll love PN-220 for the super-slimming rush of thyrotropin, PC1 enzymes, and that zesty hint of lemony leptin that zaps away fat, muscle tissue, and some nerve sheathing," PepsiCo spokesperson Ned Caen said. "But you'll drink it for that refreshing cola taste." Despite an FDA label warning of potential cardiac arrhythmia, renal shutdown, intestinal necrosis, and spontaneous erosion of the meninges, plans are underway to debut Pepsi Negative-220 in early October. "For radical and uncompromising weight loss, it's the cola," Caen said.
From The Onion

Thursday, August 18, 2005

Nobel Foundation Urged to Strip Lobotomy Prize

From the August 2005 edition of Psychiatric Annals (not, to my knowledge, available on-line):
Relatives of people who underwent lobotomies between the 1930's and 1970's are petitioning the Nobel Foundation to revoke the 1949 prize for medicine given to Egas Moniz, the Portugese neurologist who developed the procedure in 1936. A new book says that of the 50,000 people in the United States who underwent the procedure, only about 10% were helped. Family members have already asked the foundation to remove or revise an article on its Web site about Moniz and the procedure.

Wednesday, August 17, 2005

Doing Away With Tips

Effective September first, Per Se, one of the most highly rated Manhattan restaurants, is instituting a 20 percent service charge to all checks in lieu of a tip. The service charge will then be used by the restaurant to help pay all hourly employees -- kitchen staff, waiters, and busboys -- a flat hourly wage.
Management at Per Se doesn't seem particularly troubled by these concerns.
Chef Keller has said he instituted a service charge at one of his other restaurants, The French Laundry in Napa Valley, and it has gone well.
A spokesman for Per Se said the stable salary -- which also comes with benefits like vacation and health insurance -- would create a more professional environment and increase motivation. He also said the customers might find it convenient not having to contemplate a tip.

Instead of a service charge, why not just increase prices by 20% (and put up a sign eliminating tipping)

Saturday, August 06, 2005

Medicare Benzodiazepine Exclusion

Psychiatric News reports on the Medicare Benzodiazepine exclusion:
Last month APA praised Reps. Benjamin Cardin (D-Md.) and Jim Ramstad (R-Minn.) for co-sponsoring legislation that would reverse the exclusion of benzodiazepine medications from reimbursement under the new Medicare Part D drug benefit. The Medicare Modernization Act of 2003 (MMA) contained language that required that benzodiazepines be excluded from coverage by the new drug benefit, which begins January 1, 2006 (Psychiatric News, February 4). Psychiatrist Stevan Gressitt, M.D., founder of the Maine Benzodiazepine Study Group, told Psychiatric News during an interview for a previous article, "The alternatives really are grim. If these patients don't have access to benzodiazepines after January 2006, then they will most likely be switched to something that is covered—an SSRI or an atypical antipsychotic. Neither one of those would be my first choice for an elderly or disabled patient with multiple medical problems who is probably taking several other medications."
Dr. Gressitt's comments don't make sense. For an elderly patient, an SSRI is often a better choice than a benzo. Most psychiatrists try to avoid benzodiazepines in the elderly due to the cognitive side effects and the risk of falls.