Yesterday my hard drive died. My computer had been acting kinda wishywashy for awhile, but yesterday it just died. I tried to restart it a bunch of times, and at first, the start-up screen was an alternating image of the apple logo and a circle with a dash through it. Then it turned into a blinking folder icon with a question mark in it. Dooooommmm! So Eric took my computer to the Apple store, where they deemed it doomed and replaced the hard drive. Because the last time I backed up my schtuff was 4/08 (and this disc is for some reason not being recognized), I pretty much lost a lot of important schtuff. Aaaarrrrggghhh.
And why did Eric have to take my computer, rather than Jess taking her own damn doomed computer to get fixin'? Well, that would be because I was laying in bed writhing in pain because I caught some nasty bug yesterday. It came on very suddenly--nausea, vomiting, myalgias, arthralgias, fevers, chills, pounding headache, dizziness, neck pain. It was awful. I wanted to die. I started making differential diagnoses for myself. The list included: gastroenterovirus, influenza, viral enteritis + meningitis, food poisoning, bowel obstruction. I kept complaining to poor Eric, "I don't feel good. I feel bad. I feel terrible", and then laughing at the stupid self-pitying I was doing. And repeat.
Double trouble, friends.
Anyway. I also have two thumbs down for this Slate article written by 2 ER docs about doctors going to work sick. This is a really poorly written article. In the introduction to their article, the authors imply that hospital-acquired infections are largely due to the spreading of germs from sick doctors. This isn't true at all; most nosocomial infections are from bacteria that are ubiquitous on our bodies and on hospital equipment such as catheters and lines (see CDC stats). For example, when a Foley catheter (a plastic tube that collects urine from your bladder) sits in your urethra for >48 hours, there is a damn good chance that some of the bacteria that naturally exist on the plastic tubing will make their way into your body. Then you get a urinary tract infection. With your body's defenses down (due to the illness that landed you in the hospital), the infection can then spread to your bloodstream. Similar stories for IV tubing, for ventilator tubing--bacteria from the enviroment getting into your weakened system, causing a bloodstream infection, or pneumonia.
Most illnesses that strike us--us being you, me, and healthy doctors--are viral. None of the leading nosocomial infections are viral; they are all bacterial. It is not true that sick doctors are causing patients to catch "new" illnesses in the hospital. That being said, it is true that a stronger hand-washing policy needs to be enforced, for all types of infection control--patient-to-doctor, doctor-to-patient, and doctor-to-equipment-to-patient, etc. But keeping doctors with a viral upper respiratory infections from working will not have a significant impact on nosocomial infections and subsequent deaths in hospital patients.
Now. Onto the rest of the article. The authors make a decent point about changing the culture of medicine such that doctors can skip work when they're too ill to properly work. But this is a statement of the obvious. "Building redundancy" is much easier said than done. What hospital is going to pay for many additional salaries per year so that there is always someone around in the case someone gets sick? None. And the logistics of scheduling x residents plus y "redundant" staff is pretty much impossible. A stronger article would have brought up a reasonable proposal to fix the "toxic culture" that keeps docs from calling in sick. A stronger article would have done a bunch of things differently, though, so I'm just going to stop there.
I also have two thumbs down for some of the criticisms of the Obama administration's rhetoric regarding the stem cell ban lift. But I'm tired of being all worked up, so I'll hold it for later.
BACK UP YOUR HARD DRIVES, people!! And wash your hands, obsessively!
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