9/11 Nuttiness #1: The Thermite Lie (Part A)

What is this in Photo 1? Why, it's that famous, mysterious yellow smoke & residue alleged by Truthers to have been created by a thermite reaction. And what is that man doing getting 2000 degree thermite residue splashed all over him? Why, he seems to be cutting a column from the remnants of the Twin Towers during the cleanup effort. It would seem that this is not thermite at all, but rather the effect of some sort of cutting tool. A tool cutting at an angle that, according to Alex Jones, "CAN'T be created by a welding tool and was designed to have the building fall in a certain direction."









Photo 2 is the job halfway done.













Photo 3, I'm sure Truthers are familiar with, as they use it quite often to bolster their silly argument that thermite was used to bring down the towers. You know, thermite, that substance that does NOT make an exploding sound when reacting? But that's a story for another day.

On EMTALA and Obama Care

The problem with allowing people who graduated from the University of Google to participate in public policy decisions is that they lack the true education, insight, and experience to truly understand the issue. Any moron can do a Google search of EMTALA. It doesn't mean you have the capacity to understand the broad application of the law. The operative words in the law are, "anyone needing emergency health care treatment." The law only requires that the physician provide "appropriate medical screening examination to any individual who comes to the emergency department seeking treatment for a medical condition (Kahn-Kothmann, ‘On-call obligations under EMTALA’ Physician's News Digest)."

The point here is that an ED can turn patients away after an "appropriate medical screening examination" which indicates no emergent condition. This screening can be performed by a PA, ARNP, or even an RN. If an emergent condition is present, the law only requires that the patient be "stabilized". This is a very subjective term. A stable, non-emergent patient could be very much in need of medical care and still not meet EMTALA criteria.

The best example of why free or cost-reduced primary care is superior to ERs and hospitals is the standard diabetic patient. I like to use this example because treatment non-compliant (for whatever reason) diabetics are the most expensive patients cluttering up our ERs and med-surg floors:
Average yearly cost of outpatient diabetic care (including doctor’s visits, glucose testing supplies, insulin, and oral anti-diabetic medications): $3500-$5000. This could be vastly decreased for most DM type 2 patients with doctor-managed weight loss assistance, which leads to a decreased need for insulin and/or frequent glucometer testing. Most oral anti-diabetic meds can be purchased from Wal-Mart for $4. Affordable primary care could even prevent development of DM2 altogether in many patients.

In contrast, the average cost of a lower extremity amputation is $61,000. Many diabetics go through serial amputations in a lifetime. Average cost of a hospital stay to treat a diabetic foot ulcer: $16,800. Most diabetics will have many of these as well. Average yearly cost of hemodialysis: $45,000. Average yearly cost to care for blindness due to diabetic retinopathy: $6300. Average monthly cost of caring for a patient with end-stage renal disease: $26,507. The costs associated with increased risk for heart disease and stroke (nearly 4x greater than non-diabetics) is immeasurable (Clark & Lee, “Prevention and Treatment of the Complications of Diabetes Mellitus”, New England Journal of Medicine). Many, if not all, of these developments can be prevented by good primary care. These exorbitant additional costs are passed on to all of us through higher insurance premiums and deductibles as well as higher overall health care costs.

You say you don’t want to pay for someone else’s health care, but what you don’t realize is that you already are! You say that doctors, not government bureaucrats, should manage health care. But how much worse is it to allow greedy insurance company bureaucrats manage it?

In which I give in to superstition

I work as a nurse intern in the emergency department at . Like many Florida towns, mine is a seasonal location. So-called “snowbirds”, retired folk who flee the colds of New England and the Midwest in the winter, spend those winters in my hometown. Due to their advanced age, snowbirds are the bread and butter of our ER. But when summer rolls around, they pack up and head home to various parts of the country. As this happens, we see fewer and fewer patients. This exodus was the catalyst for an offhand comment that sparked a furor of controversy in my workplace. The comment was this (or something akin to it): “Boy, things really have slowed down since May.”

For those unfamiliar with medical culture, words like “slow”, “quiet”, or “bored’ are strictly verboten, for fear they will spark a terrible catastrophe. Now I, in my naivety, believed that nursing school is so rigorous and concentrated on critical thinking that no RN could truly believe that words directly cause physical things to happen. I was wrong. An RN gave me a killer look and told me that I was never to say that word at work again. Thinking that she was half-joking, or that her belief was more about culture and tradition rather than a true superstition, I pushed her further. I told her I believed in “evidence-based practice”, not voodoo medical mythology. Now, this nurse was a professional. She didn’t blow up at me or anything. She just gave me the silent treatment.

I decided it was best to leave it alone and went about with my work. Half an hour later, an ambulance crashed into a tree at the entrance to the hospital. It was a relatively severe wreck with three injured patients. HIPAA, of course, prevents me from giving any more details about the crash victims, so let’s just say it was pretty bad. It certainly constituted what many nurses would consider reason never to use the word, “slow.” You might think my confidence would be shaken by such an event. After all, I said the word and the consequences were apparent, were they not?

And I might have become a believer on the spot, had I not an elementary understanding of critical thinking. Of course, the most glaring fallacy in this superstition is post hoc, ergo propter hoc. Simply put, CORRELATION is NOT CAUSATION. The second fallacy committed here is confirmation bias. People don’t notice all the times the ER goes apeshit and no one said any of the dreaded words. Furthermore, they forget all the times someone said a taboo word and nothing happened. Finally, there is not one shred of credible evidence that anyone has ever been able to use thoughts or words to directly effect physical outcomes. If you have such evidence, I know a way you can make a quick $1,000,000. Our ER is a receiving unit for psychiatric patients deemed a danger to themselves or others. We sometimes fill a whole section of the unit with these “Baker Acts.” One common thread amongst these patients is the tendency toward magical thinking. My question is: If the nurses have the same psychoses as their patients, who’s taking care of the nurses?

Despite the fact that all reason and evidence were on my side, however, I became the bad guy that day. I caused this horrible thing to happen. My arrogance was the reason for other people’s suffering. And that’s when I had my change of heart. No, I didn’t suddenly become a magical thinker. I didn’t even begin respecting my coworker’s preposterous opinions. What I did was allow them to censor my words. I gave in to the pressure and rescinded the rights granted to me by the First Amendment of the Constitution. I pledged that I would never utter the forbidden words at work again. I did this so I would not be hated by my coworkers. On one hand, I am ashamed of myself. On the other, can you blame me?