Cowering at home for three years as Burning Man prep

by philg

Most of the folks whom I’ve met at Burning Man (attended in 2014 and 2015) were California residents. Thus, some of the Americans who most enthusiastically embraced school closures and lockdowns have found themselves stuck for an extra day or two on the Playa. Cowering at home from 2020 through 2022 could be considered prep for this year’s Burning Man, in which the car gate was closed by authorities due to deep mud.

A couple of tweets from the organizers:

The airport closed on Saturday, supposedly, but there are no NOTAMs for 88NV in the official FAA system. An AvWeb story:

(Note the “shelter in place” phrase, mirroring the language of the San Francisco mayor in 2020: “Homeless individuals are not subject to the shelter in place order”)

From 2015, not the best leggings for mud… (my original caption: “Russian journalist”):

Maybe a good mud vehicle?

A hard “no” on this one:

This probably wouldn’t work either…

Related:

  • Burning Man for turboprop pilots (links to the rest of my photos)
  • the New York Times, which said that a 12-18-month lockdown was the best thing that ever happened to K-12 kids, now reports that a 2-day lockdown requires near-divine intervention: “By Sunday afternoon, a White House official said President Biden had been briefed on the situation and that administration officials had been in touch with state and local officials.”
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How’s the Gender Pay Gap doing one quarter of the way through Joe Biden’s reign?

by philg

Happy Labor Day for readers who irrationally choose to work rather than enjoy the welfare lifestyle (analysis of spending power).

We’re about one quarter of the way through the glorious reign of Joe Biden. How’s the gender pay gap doing? The Wall Street Journal:

How are these folks surviving in D.C. unless they’re getting bribes from foreign governments and companies anxious to get favors from the central planners?

The median man on Mr. Biden’s staff earns $105,000, while the median woman gets only $84,000.

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New York Times now says it is all of Florida’s coastal waters that hit 101 degrees

by philg

“What’s Next for Hurricane Season” (NYT, today):

… the heightened ocean water temperatures that grabbed headlines this summer for bleaching coral and turning Florida’s coastal waters into something akin to a hot tub. Scientists believe that climate change has contributed to the warming oceans. The abnormally hot water temperatures provide more energy to fuel hurricanes…

Loyal readers may recall Being boiled alive in the 101-degree ocean (according to NYT) in which the New York Times said that one buoy “in the Ocean Off Florida” hit 101 (it turned out to be a buoy in a 1-6′-deep puddle inside Florida, cut off from the actual ocean by the Florida Keys). Here’s the headline, complete with photo of the open ocean where the 101-degree temperature wasn’t measured:

In August, it was “a [single] high reading”. One month later, the “hot tub” temperatures have spread to most or all of the “coastal waters” surrounding Florida.

What does seatemperature.net say?

Water temp at the most familiar Florida beach is between -1 and +1 degree of the recent historical average. A typical hot tub is at 102 degrees. The current Miami Beach water temp of 86 is about where a recreational swimming pool would be set to. Over the past 7 years, it seems that the high temp for July, August, and September has been 89. In other words, what the New York Times calls “abnormally hot temperatures” are in the middle of the recent historical range.

What have elite New Yorkers been doing recently to address the climate change that they decry? Getting into fossil fuel-powered vehicles and going to see Bruce Springsteen perform in New Jersey. Instead of spending $2000+ on decarbonizing our economy, they’re listening to a geriatric fellow Democrat sing songs that they could stream for free. (Separately, these are the same folks who say that schools should be closed and the peasantry locked down any time that a respiratory virus threatens Gotham, yet they’re gathering in a crowd of 50,000+ to spread vaccine-resistant SARS-CoV-2 variants?)

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Medical School 2020, Year 4, Week 27 (Advanced Surgery, week 1)

by philg

I am excited to start a surgical elective with my favorite retired trauma surgeon who led our first-year anatomy lab. Jane, Buff Bri, Southern Steve, Lanky Luke,, and myself each choose various surgical techniques to work on for the next two weeks. We have three untouched cadavers to work on. 

We meet at a local coffee shop that is walking distance from the anatomy lab. Jane and I bring our new puppy for socialization! The trauma surgeon spends the initial 30 minutes giving us puppy advice from her experience training service animals. We each identify various surgical techniques to focus on. Jane, Luke, Steve and myself will use our time with the cadavers to focus on abdominal exposures and neck dissection. Bri, applying to neurosurgery, will perform an external ventricular drain (EVD) and various craniectomies for aneurysm exposures.

The next day, we meet at 9:00 am in the anatomy lab. We focus on placement of thoracostomy tubes (“chest tubes”). Our professor describes the triangle of safety bordered by the latissimus dorsi, pectoralis major, and the imaginary horizontal nipple line. We pair up. I extend the cadaver’s arm to open up the rib spaces. It’s no small feat due to the rigidity of the joints. Jane makes a small incision and then uses Metzenbaum (“Metz”) scissors to dissect down through the subcutaneous fat and through the intercostal muscles. “The surest way to get kicked out of the OR is to use Metz to cut suture. Metz are incredibly expensive and ruined by cutting suture.” Jane then takes a Kelly clamp and tries to push through the last centimeter of muscle and pleural lining. “Heave!” exclaims the trauma surgeon. “Push harder!” With an audible pop, Jane shoves the instrument into the pleural cavity. “Good! It’s a lot more force than you realize.” She then does a finger sweep. “I feel the lung!” She then smoothly places the chest tube. “Some people will say to orient the chest tube towards the apex for a pneumothorax and towards the base for an effusion. The apex always works.” 

My turn. Jane holds the arm up while I make an incision. “You’re really digging deep!” the trauma surgeon comments. “You have just made the most common mistake of interns and ED docs. Don’t tunnel up along the chest wall to the axilla; go straight to the ribs.” Once I pop into the pleural cavity, I struggle to advance the chest tube, unable to push through the resistance. The trauma surgeon takes a feel sweeping her finger in the cavity. “Wow, feel all the adhesions. This patient must have had a bad pneumonia causing all this scarring of the lung to the pleura.” She adds, “This is how you really hurt a patient. If you just blindly shove the tube in, you can tear the lung causing bleeding or a bronchopleural fistula [connection between lung airway and outside]. Always, always feel for adhesions with the finger thoracostomy before you insert the tube.”

Thursday morning we meet at a local coffee shop to discuss rectal bleeding and peptic ulcer disease. The nearby coffee drinkers must have loved our discussion on the significance of the “sweet smelling black loose melena” versus “red-streaked formed stool”. Trauma surgeon: “Blood is a spectacular cathartic.” Bri: “If a patient is bleeding out, they are shitting out.” The trauma surgeon chuckles, “Exactly.”

Statistics for the week… Study: 2 hours. Jane and I watch a section of Acland’s Video Atlas of Human Anatomy over wine to prepare for next week. Sleep: 7 hours/night; Fun: 2 nights. Example fun: weekend AirBNB with Jane’s family, including a 6-month-old nephew. There would be less depression and anxiety in this country if everyone held an infant once a year.

[Editor: It might be best to hold someone else’s infant. “Parenthood and Happiness: a Review of Folk Theories Versus Empirical Evidence” (Hansen 2012; Social Indicators Research) says “people tend to believe that parenthood is central to a meaningful and fulfilling life, and that the lives of childless people are emptier, less rewarding, and lonelier, than the lives of parents. Most cross-sectional and longitudinal evidence suggest, however, that people are better off without having children. It is mainly children living at home that interfere with well-being…”]

The rest of the book: http://fifthchance.com/MedicalSchool2020

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The environmentalist and 40 tons of snow

by philg

2016… “Kevin Costner – “It’s time we woke up to reality””:

My Indian heritage begins in Noble County, in Cherokee Outlet, which is why I consider myself to be a true American. I love and respect my country, its Star-Spangled Banner and the idyllic vision that goes with it. I love its wide-open spaces, its history and its roots, its many resources, the opportunities it gives, and its capacity to always bounce back. If that’s what it is to be patriotic, then that’s what I am! But I’m no fool. This country is heading straight for disaster if we don’t change the way we live. Today’s society is marred by racism, greed and cynicism, and we need to fight this every single day.

As a Native American who loves wide-open spaces, a lesser version of Kevin Costner might question the wisdom of expanding the population by 100+ million via low-skill immigration (the previous batch of migrants had such a positive effect on Native Americans?). But the actual Kevin Costner in 2018 was all-in on welcoming as many migrants as possible, especially those with dependent children who can occupy previously open spaces in American K-12 schools and health care facilities.

Now that Costner has been sued by his wife, we discover what the carbon footprint of an environmentalist is. From the Daily Mail:

Later in the morning, Baumgartner shared further details of the family’s luxury lifestyle including Christmas parties that saw them truck 40 tons of snow to a 10-acre plot they also own close to their main California house just for the event.

Baumgartner described how they would hire ‘all the animals from the stable in Bethlehem for the children to ride, as well as a forest of fir trees and would have toboggan runs built.

She said the plot is also used for birthday camping events that would see them pitch 40 tents for their son Cayden and his friends and hire taco trucks to provide food.

Separately, the plaintiff is demonstrating that child support is the new alimony and the best way to get profits on top of whatever is provided in a prenuptial agreement:

The mom-of-three initially asked for a monthly child support total of $248,000, which Costner, 68, said he was opposed to. … [earlier in the article] During his deposition two weeks ago, the Dances with Wolves star put his monthly living expenses at $240,000 but wants to pay his ex no more than $60,000 per month.

Baumgartner, who moved out of the marital home last month following a court wrangle, said her new $40,000-a-month rental property in Montecito does not compare to the one she left behind.

A legal filing lodged with court last week said: ‘Unlike Kevin’s Beach Club Compound, the September rental is on the mountain side of the freeway.

‘It does not have beach front access, nor is it walking distance to the beach, and has no scenic view.’

Costner was not only the primary breadwinner, but the only person making money recently, and Baumgartner says in her filing that she has no income

Remember that child support revenue is tax-free. So if, in addition to whatever she makes under the prenuptial agreement, the plaintiff does get only the offered $60,000 per month, that addition will yield a spending power comparable to what a Californian earning nearly $1.5 million per year can spend.

Notice also how the newspaper makes it sound as though the decision to spend what would have been the kids’ time and money in family court was a mutual one. A subhead refers to the plaintiff and defendant as “the warring couple.” A reader would have to scroll down a few pages to learn that it was the wife who had this idea and filed the lawsuit.

Circling back to the main theme… how is someone whose carbon footprint includes multiple houses, the fuel necessary to truck in 40 tons of snow, etc. able to call himself an “environmentalist”? Also, if your own lifestyle costs $10+ million/year to maintain, is it reasonable to criticize other people for their “greed”?

Related:

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Why are there still 65,000 customers without electricity in Florida?

by philg

Hurricane Idalia came through northern Florida on Wednesday, August 30. Roughly 250,000 customers lost power. The situation at 10:00 am today, three days later:

It looks as though much of the problem is with two areas served by coop power companies (the numbers below are total customers then customers out):

They’re serving counties that were in the direct path of the storm. I’m wondering if they don’t have the hurricane-hardened infrastructure that we have in South Florida, where hurricanes regularly occur. Our transmission lines here are high above any trees that might fall. Delivery to neighborhoods is via underground cables. Is the problem up north simply that fallen trees have cut vulnerable lines? “About 40,000 linemen” were pre-positioned for Idalia, as for Hurricane Ian. But it seems as though the problem of restoration is tougher, at least on a per-customer basis (the affected counties are sparsely populated so maybe an entire power grid has to be reconstructed to restore 10,000 or 20,000 customers).

As the Bobs asked in Office Space, what is it that the 40,000 linemen actually do?

Separately, with all of the progress that has been made since Joe Biden took office, why don’t we have a gender-neutral term to replace “lineman”? What about electric grid workers who identify with one of the other 73 gender IDs recognized by Science?

Related:

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Taskflation with Task Rabbit

by philg

After placing an order for delivery from IKEA, the company’s software automatically pinged me with an offer for assembly from Taskrabbit.

August 27:

Today:

That’s 142 percent inflation in less than a week. Bidenomics or do IKEA and Task Rabbit together underestimate how long it takes to put together IKEA furniture? (in this case it was an outdoor cabinet/bookshelf, a TV stand, and four inserts for the Kallax bookshelves)

The fine print on the estimate says “depends on the Tasker you select,” but I don’t remember selecting anyone. The taskrabbit site chose for me.

(I will say that the guy who showed up did a good job. I’m not sure that he could have worked substantially faster. Maybe the idea was that someone was going to accept this job for $15/hr including the Taskrabbit markup? And perhaps the estimate didn’t include the “trust & support fee”?)

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11 percent inflation in a 3 percent world

by philg

We’ve been in our house for a little over a year and it is time to order some additional furniture. I spent a little time on the web sites from which I ordered a 1-1.5 years ago and, for those products that are still offered, compared prices.

A chair that I ordered a year ago for $179:

The same chair today, offered at $199:

Up 11 percent in our world of 3 percent (official) inflation.

How about IKEA? Here’s a shelf that we ordered in May 2022 for $200:

It’s now $260. Inflation of 30 percent in less than 1.5 years.

The $50 chair?

Now $65, also up by 30 percent:

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Medical School 2020, Year 4, Week 12-24 (Interview Trail)

by philg

After a long hiatus due to my laziness and the author being a resident, here’s an addition to Medical School 2020… It’s the fall of 2019. SARS-CoV-2 is just beginning to build mindshare in Asia. Our hero is looking for a job…

Three months off for interviews, each of which is progressively less exciting.

There are three classes of surgery programs: academic, community, and hybrid. Academic programs typically require at least two years of research in addition to the 5 PGY (post graduate) years. Our hospital’s residents warn that academic programs struggle to deliver case volumes for training. Residents may participate in complex robotic whipples, but won’t learn bread and butter procedures. The best opportunities are grabbed by fellows, who don’t exist in community programs. Many academic programs ship residents off to satellite community hospitals with higher case volumes that enable better training for going into general practice.

My first interview is at a community program in a comfortable suburb of a Northeast city. After checking into the Best Western, I walk around the main street for an hour before I head back to change into business casual attire for the evening reception at a local bar. Three other likely applicants are waiting in the lobby for the 6:30 pm shuttle.

An applicant from a Southwestern DO school explains that he doesn’t know much about the program or the area. “Beggars can’t be choosers. I’m just happy to get an interview.” An applicant from a prestigious medical school is less grateful. “I don’t expect to go to a place like this,” she says, “I’m using it for practice.”

Several residents and their families are enjoying beer and finger food. A couple of attendings, including the program director, are chatting with applicants about hobbies. At 8:00 pm, the attendings leave to allow the residents to speak more candidly. “One important factor that I wish I had considered in applying for surgery residency is the level of trauma exposure,” explains a PGY4 (rising chief). “We are not a level 1 trauma center. We stabilize traumas en route to the main city trauma center. We get our sexy GSWs [gun shot wounds] in our fourth year rotation at the trauma center.” There are advantages: “You don’t get as many trauma cases, but you don’t have to spend half of your time being an amateur social worker.”

I wake up at 5:00 am for an early morning walk to the hospital for 6:00 am remarks over catered Chick-fil-A. The program director, a soft-spoken, humble 60-year-old MIS (minimally invasive surgery) surgeon, introduces himself and describes the unique opportunities at the program. One that appealed to me is the chief service. “We are proud to still offer a chief service. Three months of the year you will rotate on the chief service where you run the ship. You interview patients in clinic, and schedule them for surgery. You do the surgery. You manage their complications. You see them at their post-op visit. We also teach you about the intricacies of billing. There is an attending available for any issues, but this is your service.” He added, “This used to be commonplace at surgery residencies but has fallen out due to insurance issues and case volumes. The administration and I are confident enough in our residents to continue this opportunity.”

(What is not stressed is that the chief duties are mostly restricted to Medicaid patients. Care of the privately insured is overseen by more senior physicians.)

We had four 30-minute interviews with selected faculty. I interview with a young vascular surgeon who moved here because the cost of housing near her NYC fellowship was beyond her means. Most of my interview with the chair focused on his love of poker. I tried to steer our conversion back to medicine by alluding to the similarities between surgical decisions and the risk analysis with poker. “If you come here, we’ll have to invite you to our poker nights.” In my interview with the program director I ask him what he is most proud of. “I am proud that I would let any graduate of this program operate on my family.”

After the morning interviews, we have a Panera-catered lunch with residents popping in and out between cases. One interviewee is from a Seattle-based medical school, “My home residency program ships their 4th year out to Chicago for 2 months,” she said over our Panera-catered lunch. “They get 10 GSWs a day and hit their numbers in a few weeks.” The program director provides some concluding remarks. “I know this is early on in the interview process. Each of you is qualified and has an exciting surgical career ahead of you. Most of you will not come here, and that is okay. We would love to have you.” He continues, “I would like to leave you with two final thoughts: First, take a deep breath, you will match. Every applicant we interview is competitive and will match. Second, get excited. You have chosen an amazing path. You will play such an important role in the lives of others. The best surgeons are humble because they understand that we stand on the shoulders of giants whose achievements have allowed our patients to trust us. Honor this pact and safe travels.”

Those who don’t have to get on a plane immediately are invited on a 45-minute tour of the hospital, which is as close as an interviewee gets to patients or an operating room. I found these fascinating and always took the opportunity to join.

(Mostly because of a lack of interest in the geographical location, I did not rank this program highly in the Match and therefore I never learned how high they ranked me.)

Lanky Luke interviewed at a new Accreditation Council for Graduate Medical Education-accredited residency program started last year by a previously successful program director who had moved to a beachside hospital. The night before the interview the interns and residents got together at an upscale restaurant featuring an open bar. “The attendings were drunker than the interns! Everyone was hung over for the interview the next day, which thankfully didn’t start until 9:00 am.” Luke loved it. “Basically you just work with the attendings day in and out. The interns operate like crazy.” Our surgery chair, however, discouraged Luke from giving this program a high rank because it would be more difficult to get a job than if he went through a more established program.

Jane returns from boot camp and two back-to-back away rotations at military hospitals. After three months she has missed a lot of our class drama. I am also not up to date on the newest gossip. To mend this, we get lunch with Ambitious Al. Jane asks about Southern Steve. “Is he still with that ICU nurse?” Al laughs, “No, he’s been dating an M2, and they are getting engaged tonight.” He adds, “Y’all should come to the afterparty tonight!” Jane asks after our classmate who had suffered a stroke at age 10 and had some trouble with one hand and his gait (see Year 1, Week 31). Al responds, “He doesnt go here anymore.” (He dropped out during the third year.)

[Editor: If his stroke symptoms prove to be mentally debilitating he can serve as a U.S. Senator from Pennsylvania.]

A few residency programs ask for a supplemental application, typically a two-page application with four questions. Examples: How would you deal with conflict of opinion between providers in the care of your patients? How would you approach one of your fellow residents not carrying his or her share of the workload? Oregon Health & Science University: “We value diversity in its many forms and strive to create an inclusive community.  Please let us know how you will both contribute to and learn from our community during your training at our program.  (250 words or less)”. Perhaps due to my failure to minor in Intersectionality as an undergraduate, I was not selected for an interview by OHSU.

The main drama and stress of this period is trying to match in the same city as Jane. She’s restricted to military hospitals and I’m restricted by being a white male with an above-average, but not top-one-percent score on Step 1 and 2. Neither of us can write our own tickets.

The rest of the book: http://fifthchance.com/MedicalSchool2020

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Hurricane Idalia, METAR edition

by philg

Here’s the part of the Florida coast where Hurricane Idalia arrived recently:

Notice that the area where the hurricane was predicted to make landfall, and actually did make landfall, is covered in wildlife refuges. In other words, no humans would ordinarily be resident in this area. What does it look like for pilots? There are two airports with weather stations: Tallahassee (KTLH) and Perry-Foley (KFPY):

How ugly did it get at Ron DeSantis’s house?

KTLH 301308Z AUTO 34028G40KT 2SM +RA BR FEW015 BKN036 OVC065 24/23 A2936 RMK AO2 PK WND 34040/1308

Winds 28 gusting 40 knots, 2 miles of visibility in heavy rain and mist, a broken layer of clouds at 3,600′ above the runway. That was around 9:08 am (1308 GMT).

What about around Perry-Foley, which is much closer to the water?

KFPY 301335Z AUTO 27033G48KT 2 1/2SM RA 25/24 A2904 RMK AO2 LTG DSNT SW T02450238
KFPY 301315Z AUTO 26037G51KT 2SM RA 25/24 A2894 RMK AO2 LTG DSNT NE T02480241
KFPY 301255Z AUTO 28050G74KT 1SM +VCTSRA 25/24 A2865 RMK AO2 LTG DSNT N AND NE P0071 T02470240
KFPY 301235Z AUTO 31044G68KT 1SM +VCTSRA 25/24 A2834 RMK AO2 LTG DSNT NE AND S P0063 T02460240
KFPY 301215Z AUTO 01054G74KT 1SM +TSRA OVC008 25/24 A2828 RMK AO2 LTG DSNT N AND NE P0029 T02470240
KFPY 301155Z AUTO 02043G62KT 1 1/4SM +RA OVC008 25/24 A2860 RMK AO2 LTG DSNT NE AND E P0046 6//// 7//// T02510240
KFPY 301135Z AUTO 04034G56KT 2 1/2SM VCTSRA OVC011 25/24 A2887 RMK AO2 P0029 T02510240
KFPY 301055Z AUTO 06030G42KT 1 3/4SM +RA SCT007 OVC013 A2913 RMK AO2 P0024
KFPY 301035Z AUTO 05024G36KT 4SM RA BKN008 OVC013 25/24 A2919 RMK AO2 P0008 T02520240
KFPY 301015Z AUTO 04019G29KT 3SM RA OVC008 25/24 A2927 RMK AO2 P0004 T02500240

About 2.5 hours of frightening wind, which peaked at 54 knots gusting 74. There was a heavy thunderstorm with rain and skies overcast at 800′ above the runway. “LTG DSNT” means “lightning distant”.

Cedar Key, Florida is a small collection of islands tenuously connected to the mainland with charming wooden buildings (i.e., dilapidated) that look like they could be blown away in a fresh breeze. Cedar Key was widely highlighted in hysterical media stories as likely to be wiped out by Idalia’s storm surge. Yet people refused to take a day for sightseeing in Orlando! “‘We Should Have Gotten Off the Island’: Cedar Key Residents Survived Idalia’s Wrath” (New York Times):

Hours after the waters of the Gulf of Mexico swept through her house, Donna Knight emerged in a windbreaker and boots to try to get her Chevy SUV to higher ground.

“It came through — the whole ocean,” she said, describing a night of howling wind, frightening bangs and flying debris as Hurricane Idalia blew through Cedar Key, a conglomeration of tiny islands connected by bridges that juts three miles into the Gulf.

By noon on Wednesday, the center of the Category 3 storm had passed, and she and her 19-year-old son knew they had survived. “We should have gotten off the island,” she said.

Officials had estimated before Idalia made landfall that perhaps 100 people were riding out the storm on Cedar Key. It was unclear how many had left the island immediately afterward.

Not a great advertisement for the Florida K-12 system…

Ms. Knight, 62, a 20-year Cedar Key resident, had every intention of heeding the mandatory evacuation order ahead of Idalia, she said. “My bags were packed.” She just needed gas and groceries, and would join her husband and mother-in-law near Orlando.

But her son didn’t want to go. “I wasn’t going to leave him by himself,” she said.

This was the absolutely the most obvious place from which to evacuate and yet 100 people (out of 700 total population; the NYT fails to provide context) decided to stay (a “mandatory” evacuation order in Florida is not backed up by COVID lockdown police tactics).

How was it in Palm Beach County, you may ask? A little windy. Hot as hell if hell were also super humid (2-3 degrees above the historical average; 3-4 degrees below the historical record). Scattered thunderstorms (common in the summer anyway). I ended up on a bug-free boardwalk in the Everglades at the Arthur R. Marshall Loxahatchee National Wildlife Refuge, a 145,000-acre swamp. I’ve been on about 15 boardwalks in the Everglades and never been bothered by mosquitoes or other flying predators. This is one of the big mysteries of Florida!

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