Sometimes life's OK, some med news, big music days

Typically I feel kind of blue when I come out of a long stretch of inactivity or inconsistency with blog posts, like I'm not imaginative, creative or committed enough to keep up with posts. After all, it's designed to be an outlet to share my thoughts, ideas and/or things I'm enjoying.

I think this is one of those times, however, when I'm not as regretful. As Modest Mouse says, "sometimes life's OK". It's been a busy past couple months with longer hours at work, applying for future endeavours, committees or commitments around work like journal club or meetings, and trying to stay active. Unfortunately, blogging isn't the only thing that takes a step back. I haven't had a long chat with my family for a couple weeks although I've shot a few emails and texts a couple times a week.

Of course, since it's been almost two months(!!) since I've posted, there's a lot to share!

First off, a rare comment about a medical matter. Over the last couple months, word has gotten out about a new decision rule to be used in emergency departments developed here in Ottawa: the Ottawa SAH (subarachnoid hemorrhage) rule. Some of the same people brought us the well-known Ottawa ankle rules, Ottawa knee rules, and CATCH pediatric CT rules, Canadian CT head rules, and Canadian C-spine rules. Some people like long walks on beaches, but these guys prefer to make RULES. Who can blame them? They make clinical decision-making for some difficult scenarios a lot more streamlined and methodical.

The unique side of things from my side is that this is the first time that I've been close to the action, so to speak. It's making some waves in local press, but it's also intriguing to see one of these rules come hot out of the oven with its results, and immediate response, critique and feedback in essentially real-time in the medical community. It is impressive that it offers 100% sensitivity, but what's even more interesting is how they're able to achieve that goal, as detailed in this blog post. You can find a more critical discussion here. It will be interesting how this unfolds in the next few months.



On to music...
The number of quality releases in 2013 continues. As previously discussed, I was a huge fan of Entertainment! and Random Access Memories which were my big two for a huge chunk of the first half of the year. In the tier below, I also listened heavily to new albums by Tegan & Sara, the National, Savages, How to Destroy Angels and Bonobo, and more.

This fall there has been another massive wave of solid albums. As solid as two-week old bread. Wait, that's not a good analogy. What's a good solid? Like a never-ending popsicle on a hot summer day.
I've been trying to simultaneously balance...

• Haim, Days Are Gone (I was waiting for it for months and gosh it did not disappoint)
• London Grammar, If You Wait
• Lorde, Pure Heroine
• Disclosure, Settle

Not to mention the much-anticipated Arcade Fire LP Reflektor coming out at the end of the month!

Lastly, in tribute of the end of the best ever shows on television, and from another great 2013 album...

A quiet Friday night

DJ Mitsu The Beats - Nightfall

Some advice...

If you see something by London Grammar, you LISTEN TO IT. I heard "Strong" a month ago and was like "how do I get more?" alas... I was disappointed. Fortunately, it turns out their Metal & Dust EP is on Spotify and all of it is excellent.

Think xx and Florence + the Machine's love child. Sounds too good to be true? IT'S NOT

Their LP If You Wait is out this September. CAN'T WAIT.

Now go!

Mind drawing a blank

It's odd, I haven't posted much recently not due to forgetting about the blog per se, or not having much going on (quite the opposite)... I guess I'm just having trouble finding topics I really want to talk about in a longer, more united post. Maybe I'll just leave it up to a "quick hits" post today:

• I did my first ever triathlon last weekend! It was a sprint triathlon (500 m swim, 20 km bike, 5 km run) and was an interesting challenge. I remember feeling more mentally and physically exhausted after the half marathon, but this was its own challenge. My relative inexperience in the open water swim and the cycle leg showed, not to mention my transitions. Fortunately I made up a lot of ground in the run. I'll be looking to do another with a long-term goal of finishing an Olympic length triathlon by the time I'm 30 , no let's say 2014...
• While "training" for the triathlon I found myself trying to challenge my times with some slightly longer run distances. Ever since I started hitting the sub-5 min per km consistently this spring, I've been pushing myself distance-wise. I'm now at the point where my all-time 8 km record I achieved in Grade 10 (2003!) of 36:45 is now within reach... my most recent run hit ~37 min, so I'm still a few seconds off. It's gonna be hard but not impossible at this stage...
• The next six months are really going to be testing my resolve and discipline as I look to go through CaRMS again. This may be the hardest I'll have to work to earn something...
• Mid August means that first "smell of fall" is on its way. What I mean by this is that there's always one morning probably 4-6 weeks before the first evidence of autumn hits where you can just smell or feel the fall air. It's kind of neat, but also kind of depressing even though I really do like fall. I don't think anyone really looks forward to summer ending. 
• As much I've been trying not to, I've been binging on a lot of music this year. I partially blame Spotify, but I think there have been a lot of solid albums that have been released so far in 2013. I'll post some of my favourites soon. 

Helplessness

First post with some substance in a while, and it's gonna be a heavy one about work. I'll try not to divulge too much in the interest of not being too specific about the patient's case but I'll try not to be vague-city either.

I'm working with the ICU team right now so I help deal with calls from other units when their patients are in trouble. There was a guy we were called about last week who wasn't really responding to anything. At first I think the nurses just thought he was having a deep sleep but over time it became clear he wasn't responding to anything. He was generally high functioning and independent before coming to hospital for a totally unrelated issue. A young grandfather and a husband. I met his family. For the better part of an hour or two we really had no idea what was going on. He had a huge work-up done yesterday for a similar issue and nothing came back remarkable. Labs so far showed nothing either. Besides him being essentially comatose (GCS ~4), he was otherwise stable. I actually had to leave in the middle of transferring him to ICU to go to clinic in the afternoon.

Later that evening I decided to look up the CT of his head because I had an inkling he had something neurological going on. He had a massive intracranial bleed with midline shift and herniation. I was floored. I don't think I've been shocked about a test result for a patient in a long time. He had imaging the day before which was pristine and overnight for no reason he bleeds.

It made me think that despite all the training we get, the hours we put in, as much as we label ourselves "experts", when something like this happens to somebody, we're completely helpless to do anything. There was nothing that was significant in his history that could have caused it, nor could it have been prevented. In a profession where we are constantly searching for answers or remedies to ailments, mother nature pulled a fast one on us where all we could do is look and not have an answer.

On the Zimmerman trial

I don't normally comment on that many current events on this type of forum but I felt compelled with this particular case. The reason is that it illustrates to me the difference between what is 'general knowledge' in the public and a further, deeper understanding of the story behind the title.

The Zimmerman trial just wrapped up yesterday with the well-known acquittal. Not surprisingly, it resulted in an immense amount of outrage among those that saw it turn into a symbolic battle of racism and civil rights in the US. As a superficial follower at that time who really didn't know much about the case, it seemed odd to me that this guy who shot this unarmed teenager got away with no sentence at all. So I read deeper...

The defence's case had a number of flaws, as outlined in this New York Times article...

1. The only witness (Ms. Jeantel) of the incident had her credibility torn apart by inconsistent testimony
2. Outside of Ms. Jeantel, nobody else witnessed the actual altercation clearly. Yes, Zimmerman was following Trayvon Martin, seemingly on a vendetta, but did Martin lunge at Zimmernan first? There's some reasonable doubt there. 
3. Florida's self-defence laws when it comes to trespassing are terrible, at best. From the same NYT article: 

The laws allow someone with a reasonable fear of great bodily harm or death to use lethal force, even if retreating from danger is an option. In court, the gunman is given the benefit of the doubt.

As a result, it's not really a surprise the jury could not come to a "guilty" verdict. What that requires is they have to have evidence beyond a reasonable doubt that manslaughter or second-degree murder was committed. Was Zimmerman out to prove a lesson? Probably. He pursued the teenager against the police's instructions not to do so. Was he profiling Trayvon Martin? Probably. However, was there reasonable doubt surrounding the sequence of events and in the context of Florida self-defence law?

Unfortunately, yes.

Friday night music: some "hip hop jazz", versatile dream pop, and new but 'classic' JT

Hey folks, I know it's been a while but I've got a few gems for you.

The first band, who hails from Toronto, is, as Wikipedia puts it, "an instrumental hip hop jazz" group. That last sentence had a lot of commas. Anyways I heard them on the radio the other day on my drive to work and a quick Shazam later I find out who they are and am currently digging their stuff on bandcamp. They're called BADBADNOTGOOD, and in a way I wonder if it refers to their skills at using they keyboard because they clearly don't know how to turn off caps lock.
In some respects they remind me of the late J Dilla and of course they have that jazz element to them that I like. Of course I'm a fan of both of the aforementioned so it's not a surprise I'm currently trying to decide which album of theirs to buy first.



The second band I wanted to talk to today I actually heard from Aaron Paul, of Breaking Bad fame. They're a duo from the Big Apple who actually cut through a couple genres. Sky Barbarick's vocals fit the dream pop mold pretty well, but the accompanying instrumentals vary from a single guitar and percussion to a more electronic vibe that fits better in one of those downtown lounges. Either way, they sound great, especially for those clear summer nights when you're up late just chilling and chatting with friends over some drinks. Have a listen.




Lastly, JT is out with a new single from his 2nd part of his 20/20 Experience album... because having the highest selling album of the year so far wasn't enough. Some vintage JT here... that's what I like.