New Plan for the Publishing Industry...

They're going to stop rearranging deck chairs on the Titanic and start colluding against icebergs.

There has been a lot of moaning by publishers and big bookstore chains about how e-books and Amazon are threatening to put them out of business. E-books are outselling hardcopy books, Amazon is undercutting  prices, e-books sell for less, so the profit to the publisher--oh, yeah, and some other guy...Oh! Right, the author-- is lower.

Doom and despondency all around.

What I'm not hearing at all is whether total book sales, e-books included, are up or down. Paperbacks are down, yes. And despite the handwringing, that doesn't mean a damn thing. CD sales are down as well, but people still buy new music. Eight track sales may never recover.

If the publishing industry as a whole is selling more books, whether through Amazon, Apple, brick and mortar or whatever, that is a net boon to writers. The potential audience is growing. People who live out in the sticks, people in countries where their native tongue isn't the standard, all can now get any book any time, via online e-book sales. This is a Good Thing.

And Amazon isn't piracy. People pay for the e-books. So the author gets something, and with the longer reach, the author should get a piece of greater overall potential sales.

E-books should not cost the same as print. Yes, the author worked just as hard on it. So did the editor. But there are savings in production, shipping, storage and returns. This is truth. And an e-book is less valuable to the consumer, since it's harder to lend, you can't sell it at a yard sale or donate it to the local library when you finish it.  If an e-book is $10 I will stick to print. And I will buy half as many books as if I can get a $4.99 e-book.

Maybe the publishing industry should try to sell more books, encourage more reading among the next generation (say what you like but the Harry Potter and Hunger Games series have done all writers a great service by introducing recreational reading to more young people) than trying to ensure they get the same cut they always have.

They need to stop rhapsodizing the longbow and crying when the enemy bring a machine gun to the field.
Amazon sells a boatload of books. Let's encourage the selling of a boatload of books.

The Doomsayers Who Cry "Wolf"

A friend of mine recently wondered why nobody takes "preppers" seriously.  I thought about it. I know I don't take most of them seriously.  My friend is an exception. He lives out in the woods, off a dirt road in an area that has a low population and lot of seasonal residents. So it's last on the priority list for the utility crews and the snowplows. It's not uncommon for him to lose the electrical grid for days on end, or to be cut off from the main roads. So he made sure he has some electricity from a solar panel array, and ha woodstove that can heat the house or cook a meal, and he always has some dry food stored. He considers himself a prepper, but I say he's just embraced the reality of his situation.

We don't make fun of the guy with a generator or a few gallons of bottled water. If your road floods twice a year, maybe you want to own a boat.

The guys we laugh at are the ones who have a bomb shelter. They guys who stockpiled 9 mm ammo after Obama won the election so that you couldn't get it in stores. The guys who bury a box of gold in the backyard.

Why do we laugh at the "Doomsday Preppers?" Why don't we take people seriously when they warn of the coming apocalypse?

Because we've gotten used to them.

There is always somebody screaming that the world will end. And it never does.

The millennium, the plague, the Mongol invasion, the rise of Fascism, of communism, the Cold War, the UN, going off the Gold Standard, Electing a Catholic president, missiles in Cuba, the energy crisis (pick one), the Y2K crisis,  weapons of Mass Destruction, electing a black president, the mortgage bubble, global warming.

We've grown numb to the cries. Everything else has proven survivable, so this next thing will be too.

Yes, there are dangers on the horizon. Many of the things I mentioned above had real potential to cause havoc, bring down the established order. Not many did. Sure, people suffered, but some people will always be getting it in the neck somewhere, and if it's not you or anyone you know, it's hard to get worked up. Sometimes, maybe we should worry, but they've become like a car alarm. Nobody looks up or calls the police when they hear a car alarm. they complain about the noise.

The average person worries about working to keep the family fed and sheltered, and wants to enjoy their few precious free moments, not spend them fretting about an apocalypse that has never returned a phone call. 

So, being busy, being jaded at the consistent ability of doomsayers to be dead wrong. That's understandable. But we do sometimes get worked up about a waning. If the weather guy on channel 4 says it will snow, everyone in the state has to run to the store for milk and bread. Why does he warrant a listen, make us look up from or lives of quiet desperation, but not the guy who warns of an impending fiat currency collapse? Both of them are probably overstating it for the ratings.

Well, it comes down to perceived legitimacy. If the President says terrorists have weapons of mass destruction, we think, since he has advisors and an intelligence agency and a foreign service and all, maybe he knows something. Turns out that's really not a good call, but it makes sense.

If you own no clothing that isn't camouflaged and have a beard like an Old Testament prophet, nobody's going to listen. If your friends are still in debt from all the Ramen Noodles and peanut butter you convinced them to buy for Y2K, they've stopped listening. I'm pretty sure Noah's neighbors saw him working on the Ark and pretended not to be home when he knocked on the door asking if he could borrow a male and a female scorpion.

And if your preps involve a defensible island fortress to hold off the UN invasion when the come for your handguns, just realize that when you have your heart attack brought on by a steady diet of MREs and stress about black helicopters, the Mooseknuckle Notch Volunteer Ambulance takes a long time to get there. And they've seen two heart attacks this year. It's been busy.

So, yeah, that's funny.

Maybe they'll be laughing at me when I am clawing at the shelter door begging for  some radiation sickness pills. But my money's on the guy who lives in the city, surrounded by leftists and minorities and world class hospitals.

The scariest power of all.

So the kiddo is really into Transformers right now. This afternoon, the wife pointed out a minivan to him that had a Decepticon sticker on it. For those of you who neither grew up in the 80s or have young children, the Decepticons are the evil Transformers, robots who can disguise themselves as everyday vehicles.

Kiddo: Is he a Decepticon?
Mom: Looks like.
Kiddo: What's his name?
Mom: I'm not sure. I think he's in disguise, waiting to transform.
Kiddo: What does he do?
Dad: His name is Suburbo. He steals your dreams.

Deaf Comedy Jam

We get a lot of patients on the ambulance who are hard of hearing. And there are a lot of accidental straight lines and perfect double entendres thrown out in everyday conversation that are hard to resist. When these two things occur simultaneously, we tend not to resist, and this leads to some escalation where we try to keep a straight face and make one another break or laugh first, without the patient actually realizing what we're doing.

Yeah, it's childish, but, hey, we're childish.

An actual exchange between my partner and I this past weekend.

We picked up a somewhat deaf elderly patient with chest pain, and transported her to the hospital. She first complained of having choked on chicken, and my partner asked a lot of "choking on the chicken" questions, while the Firefighters and I made the obligatory comments about how that could lead to blindness, carpal tunnel, etc. I won that round, since the Firefighters always break first.

Then we did our assessment and drove her to the hospital. I was driving, so my partner was in back treating the patient. When we pulled in to the ER and I opened the back doors, he was looking frustrated at her arms and taping some gauze over a missed IV attempt.

Now, since A Hospital Which Cannot Be Named wants all the work done for them, like lab draws and IV starts or they get bitchy, we hate to bring in a patient without a line established, so he asked me to hop in and take a look at her right arm while he looked for another site on her left.

I jumped in the truck and checked, and, while her veins were lousy, I did find a likely candidate and successfully started an IV, and drew blood.

This is the dialogue which followed:

Me: I'm in.

Him: Good job.

Patient: Oh, you're good.

Me: Thanks.

Patient: But you must hear that all the time.

Me: Once in a while, but it's always nice to hear.

Patient: I hardly felt you put it in.

Him (quiet enough so I heard it but the patient didn't): He hears that a lot.

So I was trying so hard not to laugh that as I finished the blood draw and started to hook up the IV tubing, I fumbled a bit so blood leaked back out of the IV catheter before I could get the line hooked up and running. Not a big deal, it just looks a bit messy. And I mean, like a few cc's of blood, not a lot.

Him: Man, we better have the ER order some O Negative! There gonna need if with you starting IVs today. That never happens to me.

Me: (in my best preschool teacher voice) Well, that's because it only happens when you hit a vein.

_____________________

The best version of the game ever was played between me and my old EMT partner Nicole, who was (and probably still is, come to think of it) a drop dead gorgeous blond. We would pretty much just drive around all day trading sexually inappropriate comments and the one who laughed the most, lost. Our partnership was completely platonic. My wife and I had dinner with her and her fiance, and we danced at their wedding.

But our conversations on the truck were consistently sleazy and inappropriate.

One time I was trying to lift the stretcher into the ambulance with a very deaf patient on it.

Lifting the stretcher is routine, but involved. You roll the cot until the head end is in the truck, then lift the foot end off the ground and roll it the rest of the way while your partner raises the wheels. After raising the stretcher, you have to roll it into a yoke and then slide one of the struts into a clamp that closes and locks when the strut hits a tiny retaining pin that keep the clamp open. Add to this the fact that the company was cheap and busy, so we slammed the stretchers into place a lot, and the maintenance was pretty sketchy, so the clamp often failed to lock, or had to be finessed into place.

The ambulance is kinda high, I'm pretty short, plus, this time I was standing in a dip, so I had to lift even higher than usual. So, I'm raising it, Nicole is lifting the wheels, then I need to roll it in, guiding it into place and hitting the damn pin just right which, in this particular shitbox truck, involved a complex slide/pull/shimmy maneuver.

So, I'm struggling a bit.

Nicole: Having trouble?

Patrick: No, no, I got it.

N: Can't get it up? It happens to a lot of guys.

P: No, it's up, I just can't get it all the way in. Happens to me a lot.

N: Well, you gotta work at it. If you put some more finesse into it, it would slide in a lot easier.

P: It's not enough to slam it in. It's all about hitting the right spot.

N: So, you're having a tough time finding the spot? That happens to a lot of guys, too.

P: (tears of silent laughter) I think I'm gonna need you to help me out here....

By which time, everything you say is dirty, since you've put your mind there, and we are emotionally as mature as the average third grade boy.

Thank God we treat a lot of very hard-of-hearing patients.

What I learned while installing a medicine cabinet.

1. There is no such thing as a standard sized medicine cabinet.

2. Stores will try, without any visible flicker of remorse, try to charge you $300.00 for an aluminum box with two shelves and a mirrored door.

3. The guy who invented wallpaper deserved to die a horrible, slow and lingering death. I hope he did.

4. My house was built in 1964. If it is representative of mid 60's American craftsmanship, it's no wonder we lost the Vietnam War.

5. Other than the outlet on the old, crappy, rusty, awful medicine cabinet, there was no outlet at all in the room. The '60's sucked.

6. But they did have the heaviest gauge wire known to man. I could have built a suspension bridge out of that stuff. Which made installing a new outlet loads of fun.

My Brief Incarceration at Catholic School.

When I was in first grade, about six years old, I came home from St Joseph's elementary school (AKA The Atheist Factory) and asked, "Mom, what does ‘strewn' mean?"

Somewhat surprised, she replied "It means ‘spread around.'"

"Oh," I said. "That makes sense."

"Why do you ask?"

"Sister Rosemary used it."

"Was that a vocabulary word?" mom asked, thinking that was a pretty advanced word for six year olds.

"No. She said that if we didn't quiet down, there would be dead bodies strewn all around the room, and when the police showed up, they'd say ‘Sister Rosemary, we understand'."

I went to second grade in  public school.

You're going to get it anyway, may as well laugh at it

Like most computer users, I get a lot of unsolicited email. Most of it is just junk, of no real interest, and gets deleted. I am happy with my marriage, the size of my penis, and my lack of cheap, under the table prescription drugs.

But once in a while, some of the stuff is unintentionally hilarious. I submit the following:

" Sir,
I am a lady accountant with a bank here in London. There is a fixed
deposit of £150,000,000.00 (One Hundred and Fifty Million Pounds
Starling) made to this bank...."

First of all, I found it amusing that the writer would point out that this is from a lady accountant. That's like when Rimmer in Red Dwarf talks about having "a woman's period." The fact you feel you have to say it means it's not real.

BUT..the part that broke me up was the "One Hundred Fifty Million Pound Starling" I got the image of an enormous songbird sitting atop the London skyline, uttering a bass "TWEEEEEEEEEEEEEET" and leaving the nation's millet supply in tatters.

Well, I found it funny.

Think of the droppings.....

Why I am a Luddite

So, at the local hospital, they have a shiny new computerized medical records system which allows nurses to pull up patient charts on the computer and view all the relevant history, meds, allergies, etc and add documentation right there.

Sounds great, right.

Well, so did the Titanic.

Ok, the problem is that now, instead of the old way when I dropped off a patient, where the nurse would walk into the room with me --maybe with a pen and paper or maybe like a really good waitress, just her perfect memory -- take my report, help get the patient moved over to the hospital cot, switch over the EKG leads, take vitals and start treatment, now they need to Pull Up The Record.

Here's a quick example of the old Stone Age way we did things, and the New Improved way.

Stone Age Emergency Medicine.

We arrive at ER. Go straight into a room with the patient. A nurse and a tech come in with us, the tech helps move the patient, the nurse poises her pen.

Nurse: What'cha got.

Medic: This is Bob. He's 56, and awoke this morning with 8 of 10 crushing chest pain radiating to his jaw and down his left arm. Took two of his own nitro tabs without relief. On our arrival he was pale, cool, sweaty, radial pulse of 92. EKG was sinus rhythm, 12 lead shows elevation in V2,3 and 4, BP 150/90, lung sounds clear, denies shortness of breath, nausea, or dizziness. Past history of high blood pressure, past MI [Myocardial Infarction, or heart attack] insulin dependent diabetic. Takes [lists meds] allergic to [lists]. We started a 20 gauge IV normal saline in his left hand, gave 325 mg of aspirin, two sublingual nitro, patient had some relief, states pain is  now 4 of 10. O2 at 4 liters, here are the bloods we drew. Any questions?

Nurse: Nope. Sounds good

Door to treatment time: 30 seconds.

New and Improved Emergency Medicine

Patient into room. Nurse out at computer, tech comes in to help.

Medic: Ok, this is Bob--

Tech: I can't take report.

M: Ah.

*moves patient over, not giving report. Goes out to computer where nurse is typing with both fingers.*

Nurse: What'cha got?

M: 56 year old male--

N: What's the name?

M: Uhm, Robert Lamontaigne. So, he's 56, woke up with--

N: How do you spell that?

M: -a-i-g-n-e. So, woke with 8 of 10 chest pain--

N: (to screen) Dammit. Do you have his date of birth?

M: Yeeaaaaaah...hang on... *looks at notes* ...May 12, 1956. So, 8 of 10 crushing--

N: Does he still live at 104 Oak Street?

M: Yeah. Sure. So two nitro with no relief--

N: Past Medical history?

M: Uh..high BP, lemme see...yeah, MI in '07, and insulin dependent--

N: Dammit! Is his PCP still Steinberg?

M: *blinks* Not a clue.

N: *to patient* Mr Lamontaigne! Do you still have Doctor Steinberg?

Bob: For my heart I have some Indian guy.

N: Patel?

B: Sounds right. The pain is coming back...

M: Yeah, so, chest pain. Got nitro and aspirin. Here's his EKG. IV in his--

N: You guys gave Oxygen?

M: No. Wait! Yeah. 4 liters. So he was in a sinus rhythm with ST changes in leads--

N: *sighs* Why won't this enter? Ok, Meds?

M: *completely lost train of report, grasping at straws* Uh...aspirin...um... Here *hands med list to nurse* So, he was pale, cool and --

N: *looking at list* Mr Lamontaigne, what do you take the Prednisone for?

B: Oh, I stopped that last May. I feel kinda dizzy...

*Partner signing frantically. Either we have a bad call or she really needs coffee.*

M: *rips page from notebook, hands over with EKG printout and med list* Yeah, have fun with Bob, here, we have a call...

N: *muttering to self* These Paramedics can't keep their reports straight.

Door to treatment time: Like a month. Dunno. I left while she was slapping the computer and yelling. Bob was looking worse than when I found him.

God, I love progress!