Emergency Medical Doctor

SoundMatters MAINstage HD - Surround Sound Home Theater Without The Wires

Recently, I had a small room that I wanted a surround home theater in but did not want the need to run wires to rear surround speakers. So I checked out the Yamaha YSP-800 and the Polk Audio Sound Bar.  The Yamaha was the better of the two for sure, but at $800 and the need for an additional amount of money for a subwoofer this was way over budget.  I had heard the SHARP SD-SP10 with new Dolby virtual 1.1 was pretty awesome but it has yet to land in the US from Japan, although I did see one on eBay but again the budget numbers did not meet.

Then I found the Soundmatters MAINstage HD.  This is a small box about the size of a cable TV box that can sit on the TV itself or above it or below it. It has 80 watts, and 3 speakers, left, right and a woofer. I opted for an additional SONY SAW2500 10" 150 watt sub for $100; this brought me to $500 dollars for the system well within budget.

The sound from this little box is really amazing.  I have been tempted to open it and take it apart to see how the richness of the sound is actually accomplished.  Sound from CD/mp3 is as good as some more expensive Cambridge Soundworks speakers I have, and the virtual surround it good enough to make me think someone is sneaking up behind me in a scary movie. The remote allows volume, bass and input control, as well as a "dialog" button that focuses spoken word towards you allowing the volume to be lowered.  This is handy when other are sleeping while you are watching sports or news late at night.  It certainly is not as good as a hardwired surround home theater, but for a small room it is excellent.  It has coaxial input and digital optical input for Dolby digital sources (it does not support DTS).  So you can hook up the digital cable box, the DVD player and have a full system ready to go.

So again, this is great for a small room where running speaker wires is difficult or just ugly, if you had a bigger room I would go for one of the Yamaha units.

ION iTT USB Turntable

Finally got the ION ITT USB turntable that I have been looking for months.  Originally, saw it on the Gizmodo blog almost a year ago. Then could find it on a number of retail sites but it was always sold out.  Finally, found it available on the Circuit City site.

It is a regular turntable that can play via RCA plug through your regular system but also a USB plug that when plugged into your computer and using the supplied Audacity software allows you to record your vinyl. You can choose to record a whole side of an album then breakdown each cut or record one cut at a time.  It can then be edited, cut, chopped, equalized and have most hiss and pops removed. When it is all cleaned up you can convert the Audacity file to an MP3 and have permanent digital files of all your vinyl.  I have played with it a few times with some 45’s, and it works well. The sound quality is pretty good with the cartridge that comes with it. I am sure if you were a hi-fidelity aficionado you would want to upgrade the cartridge, but this was good enough quality for me.

ION USB Turntable Vinyl Records

French Press Coffee

Well in my continued quest for the best cup of coffee, a colleague caught my interest explaining how he only makes coffee with a French Press.  Well, I went out to get one. Found one for about 15 dollars at Target, nothing fancy but works well.  Amazon has the same one on the attached ad.  Did not have any whole beans at the time so through some Maxwell House Slow Roast in the container, filled with near boiling water, stirred, waited patiently for 4 minutes, pressed the plunger and voila, one of the best cups of coffee I have every had.  The press retains all the oils, and richness that the coffee can offer.

As a result I have also rediscovered the Porto Rico Import Company in NYC.  They have great weekly and monthly deals on whole bean blends.  I prefer the City Roasts, and the Mocha Java and Northeast blends are very good.  On sale they are as little as $3.99 per pound.  This week their Vienna Columbian is on sale for $3.99, $5.99 for decaf.  Give them a try.

French Press coffee

Geico Rates Drivers By Education and Job Status

Is this fair?  So Geico actuarials are out there rating their customers based on level of education and job status.  They feel that this correlates with some decreased level of auto accident risk if you have received a higher level education and hold a job. Is this wrong? Apparently, NJ Assemblyman Neil Cohen thinks so and to solve it, as is always the case in New Jersey, you introduce legislation to limit what businesses can do.  Then they wonder why few large businesses and corporate headquarters stay in this state.  As Mr. Hoy points out Geico is out to make money by limiting risk.  Of course they could be wrong with these stats and lose money and have to raise rates, and then their customers would have the option to find another insurer.  Their customers also have the right to go to another insurer if they feel that this rating system is unfair. I am sure they also rate people by how old they are, whether or not they are married, have children, the type of car they drive and any accidents or summonses they may have had in the past. Does that sound discriminatory? You see it is all about statistics, if people who drive Mustangs have more accidents than those who drive Civics, then the Mustang drivers have to pay more to balance the risk. If the statistics bear themselves out then why shouldn't Geico be aloud to do this or any car insurer for that matter?

My question is why can’t malpractice insures do similar by rating prior malpractice cases?  If you are named in case, even before it is brought to court and a determination of guilt is made your malpractice premiums go up.  If you are named in a case and the case is dropped, your premiums go up.  It is ludicrous.  Why can’t the actuarials rate the risk based on the merits of the case, if the case is dropped there is very little or no risk, if a physician loses a case then the risk would be higher, but even then the individual case risk should be weighted individually.  I know I am living a pipe dream, perhaps I am even smoking the pipe, but it would be fair to the customer….the physicians.

Geico NJ Auto Insurance Medical Malpractice

Batman Versus Osama!!

I have always been a big Batman fan; from the hokey days with Adam West in the 70's to the modern day “Batman Begins”, but now the Caped Crusader is ready to fight terror wear it has begun.  Batman will be hunting down Osama bin Laden and whoopin his butt! Although, the DC Comics release has not yet been announced I cannot wait.  

If movie rights are made I hope the direction goes to Christopher Nolan who directed “Batman Begins”.  IMHO this was the best Batman movie ever.  If you have not seen it you need to buy it, rent it or borrow it as soon as possible.  Even Mrs. EMDoc enjoyed it, and she never likes any movies like this...she may like it because Liam Neeson is in it but that is for her to comment on not me.

Without spoiling it, the best part of the movie for me is when Bruce Wayne is finding all the toys and gadgets he will use while fighting crime.

Batman Osama bin Laden

Tablet PC-Continued

Regular readers will remember the tribulation with my Tablet PC.  It has already been a couple of weeks, and finally the Tablet is up and running.  The second install of Windows XP for Tablet PC 2005 went fine...the first was quite quirky so had to reformat the drive and try again.  So of course I then thought I had everything ready.....not so fast there EMDoc.  Turns out I needed all the drivers for all the Tablet PC functions, i.e., video display(wave-like irregularities on Internet Explorer), digital pen(non-functional), side buttons(non-functional), etc.  Luckily a quick search yielded them at the HP/Compaq website.  This site was indispensable and I recommend anyone who has a Tablet PC to go there and upgrade to the latest drivers.  Hope this helps anyone out there with the same issues.

Computers

Flight 93 - With Great Courage and Resolve

I just finished watching the A&E channel's TV movie, “Flight 93”.  It is going to be on over the next few days and I urge you to watch it.  I have not been one to watch movies, shows or read books about the events of 9/11.  I felt that living nearby in New Jersey and preparing  my Emergency Department was more than I wanted to remember, but I have always thought the victims of 9/11 were the first soldiers in the “War on Terror”.  Those on Flight 93 possibly more than the others. This is not to belittle or slight any other victims. It seems likely to me that those on Flight 93 were the only ones who had some time to really figure out what was going on and take action.  Those on the other flights and in the WTC and Pentagon did not have much time to react.

Anyway, the movie should be watched, especially by those away from the northeast and midatlantic region who in my travels I find have quickly forgotten this day. As an American, if you do not get angry or sad, after watching this and all the memories it brings back then you need to question your citizenship and move to some other more socialistic country that will coddle you like a whining babe to your grave.

I would also consider contributing to the National Park Service Flight 93 Memorial Fund.

Technorati tags: flight 93 september 11 charity

External CD-ROM Drive

Well, with all the trouble with my tablet PC, I was in the market for an External CD-ROM Drive.  So again, I thought this would be easy enough, go to my local CompUSA and pick one up.  So I get there and they have a lot of internal DVD, CD internal drives.  Of course the external CD-R drive is sold out.  So I am off to Best Buy. Here they had empty shelving where the 2 external CD-rom drives are supposed to be. Ask the sales person, when they might get them in...”Gee, I'm not sure they are not very popular, why don't you get a DVD drive instead?”  If they are not very popular then why are the sold out!(dumb ass)  If I needed a DVD drive I would have bought one, and not asked you!  So off to Circuit City, they always have had things I have needed in the past.  Unfortunately, they have restructured their computer department, and are not selling more notebooks it seems than CompUSA, at the cost of eliminating most of their peripheral and computer upgrade stock. Alas, no External CD Drive here.

So I get home and cruise the internet computer shops.  Finally, Tiger-Direct is an oasis in the desert!  Mind you the assortment of  External CD drives is limited, in fact they only offer one, but for those who are interested here is the link. Hopefully, this will save you some time and effort.

Tablet PC's

I've been using a Compaq TC1000 Tablet PC for a little while; using it more like a small laptop and less like a tablet.  I love it's mall size and portability. Unfortunately, the hard drive crashed. So I figured this is easy enough, I'll get a new hard drive and buy Win XP Tablet PC edition, install and be good to go. (It's interesting that Rory's tablet died recently...a tablet conspiracy perhaps....I digress)  So I went online to find WinXP Tablet....I searched.......I searched some more........I tried the Microsoft Online Store, surely Mr. Gates would allow it to be sold here.....nope, not there.

Fortunately, I have some inside contacts and I should be able to acquire this product soon, legitimately of course, but what for all the folks who can't? Microsoft, Mr. Gates....Bill! Tell me why!? 

COFFEE-The Elixir Of The Gods

As a provider of Emergency Healthcare it is almost a given that I am a coffee drinker.  Unfortunately, the great majority of coffee available in hospitals is almost unpalatable.  I have had coffee from pots that is so thick it has to be watered down by 80%, coffee from one cup machines that seems as if it was stripped from the bark of a burned tree, and even as a last resort a cup of instant Sanka with a teabag dipped in it to get some caffeine! This is almost Webster’s definition of desperation.  There is consistency however with a small packet of Maxwell House instant coffee.  The problem is they are hard to find, so when I see a box of them I grab it!  Yes, instant coffee is bad, but at least it tastes the same everytime.

If I had a position where I could go out for coffee, there are a number of local choices; Dunkin Donuts, WaWa, 7-Eleven, Starbucks, and a couple small local shops.  Starbucks and the local shops tend to have the very dark roasted bitter west coast style coffee, which holds up well to a double of cream, but otherwise they can keep for the price charged.  That leaves the high volume coffee heavyweights, Dunkin, WaWa and 7-Eleven.

7-Eleven, has never been a favorite of mine.  I don’t they have the turnover necessary to keep the coffee fresh.  It is therefore usually old and burnt in taste, causing me at the same time to purchase some form of antacid.

Dunkin Donuts is still a very good cup of coffee, it has faltered somewhat in the last 20 years, and is not quite as consistent from store to store as I remember.  Best part is you can buy a box of it read to go for meetings or Saturday morning soccer games where none of the parents are ever awake.

Finally, the current coffee heavyweight champion is WaWa. For those of you not in the Tristate area, WaWa is the ultimate convenience store.  It is a coffee lover’s heaven. At my local shop they have an employee during peak hours whose sole purpose is to keep the fresh pots of coffee brewing.  They have every size and fixing you would need, and a huge variety of roasts; Dark Roast, Regular, Jamaican Blue (my favorite), Kenyan and of course all the assorted flavored coffees for those who are not truly coffee connoisseurs.  Unfortunately, WaWa is a privately owned company, not a franchise and I cannot purchase a store of my own or I would.

At home I am just starting grinding my own coffee beans again. At present I haven't found a decent place to purchase a variety of roast and beans from around the world. If you know of one that can be accessed online, drop me a comment with the link.

Condoleezza Rice

Now here is a woman I would vote for in the presidency.  Eloquent, well-spoken, probably a genius, yet a huge football fan.  What is not to like? The other day she spoke:

"Across the empire of Jim Crow, from upper Dixie to the lower Delta, the descendants of slaves shamed our nation with the power of righteousness, and redeemed America at last from its original sin of slavery," Ms. Rice said in a speech at the University of Alabama in Tuscaloosa.

You can also watch the speech here.

MEDIC!

This was an enjoyable read.  I’ve been trying to read more for recreation rather than for career and work lately.  I found a brief review of MEDIC! The Story Of AConscientious Objector In the Vietnam War by Ben Sherman, in a magazine and thought it sounded good.  It’s the story of a guy who tried every legal way he could to avoid using a weapon when he was sent to Vietnam.  He is assigned to be a medic…which he chooses to do without a gun…under fire.

As the story progresses he proves himself a worthy part of his unit under fire…there is a great story early on in the OR on a hospital ship that is reminiscent of the conversations in “MASH”; funny and truthful at the same time.  While this is supposedly a true story, the ending just didn’t seem believable.  

Overall, this is a great summer read.  I finished it in 3 evenings…haven’t read a book that had that effect in some time.

Australia's Beleaguered Emergency Departments Suffer

Beleaguered Emergency and Trauma care system

Art Kellerman writes a great piece in the Washington Post this week. He is an emergency physician and unlike many of us who are too caught up in our day to day existence of making beds available, trying to deal with a full lobby of patients waiting to be seen and hardly a chance to think of the unthinkable, he has thought of it and realized the painfully obvious to all of us in the specialty.

He writes:

Faced with the twin specters of mass casualties from international terrorism and emerging biological threats, our government has failed to take effective action on either front.

International terrorism's weapon of choice is explosives -- improvised and otherwise. The London attacks and the devastating Madrid bombings are only some of the more recent examples. Over the past decade terrorist bombings have caused many civilian deaths and injuries in Israel, Russia, Bali, Colombia, Iraq, Spain, Egypt, Yemen, Kenya, Tanzania, Argentina, Afghanistan, the Philippines and other places, including two U.S. embassies in Africa.

No argument there. He goes on:

...the federal government has turned a blind eye to the problem. Across the United States, underfunded emergency rooms and trauma centers lack sufficient beds to meet their daily mission, much less absorb large numbers of victims from a terrorist attack. Few ambulance personnel know how to assess a blast scene or properly evaluate multiple casualties from a bombing. The tiny amount of federal funding ($3.5 million) devoted to trauma systems planning and development is being targeted for elimination by the House.

Only 3.5 million dollars!!!!! But wait folks, it gets worse!

But at least we are safer from biological agents, right? Well, no. Two years after SARS had a devastating impact in Southeast Asia and in Toronto -- arguably one of the most medically sophisticated cities in the world -- we are woefully unprepared to handle a recurrence of severe acute respiratory syndrome. We are even less capable of meeting a far more deadly threat: the emergence of a pandemic strain of influenza from Southeast Asia.

The rest of the article, is right on the mark...we in emergency medicine especially those who experienced 9/11, are praying everyday and every minute that it doesn't happen again.  We need to pray harder though that the small street bombings in London or Madrid do not materialize at our shopping malls, movie theaters and ball parks.

Pray with me...

Things I've Learned

I have known the Drama Queen for many years now. In her latest post she reveals her maturity is beyond her years.  I am not sure I knew all of these little nuances in life at the same time she did, especially:

“There are things you need to get over in life no matter how hard you think they can be”

“Little kids can tell what is going on”