>DAY 1



Preventing falls? C-PAP or tai chi?

Probably not.



Ice cave collapse

Finding myself in the crevices/between places

Where I do not belong

Radio this morning: Air France jet disappears on route.



Shaken-baby syndrome

Blast injuries

Death—it’s just the tip of the iceberg

Acute stress disorder

Emotional recovery

Exposure therapy

Maslow’s hierarchy

Desensitization

Thought stopping

Cognitive restructuring

Safety in the world

All things undone

Feeling hits me

Life is a trigger

Reminds me of my essential loneliness

Inability to connect/to be with/to belong

To become

Reminds me of death

Reminds me of the essential misunderstandings that encase a life/mine



Things unsaid/said wrongly

The problem of re-reading

The problem of hope

The problem of expectations and false maneuvers

Hidden motivations



It’s all memory anyway

Nothing really happens. Or is that.

Dissociation. Speaking.



Hemipelvectomy.

Where do I belong, hanging

Between life and death, favoring

Death, always favoring death because

Death always prevails. Always.

And time is such a useless concept in the face

Of death. How could it matter, if I am going to die

Anyway. There is the odd concept of waste. Waste of time.

Wasted food. Wasted resources. Waste of energy.

But if energy-matter can neither be created

Or destroyed (and how could that be so?)



Then what is waste?

Wasteful/useless

The same? Or different?



Top 10 Trauma Center topics

*hemostatic dressings

*trauma systems designs

*goal-directed resuscitation

*human genome response to injury (why am I not surprised by this?)

*factor VIIA

*artificial fascia

*endovascular surgery

And a couple more I don’t remember

Learnings? Not sure what I learned today.



DAY 2



Can’t explain these sudden dives and tumbles, feeling bad about self

Comes and goes

Best to learn to “live” with it.

Life is short.



Fresh whole blood in Tikrit

Routine, every day volunteers

Sitting in the mess tent with nothing else to do

Injury severity score

But how do they get used to war?

Even as medical providers?

Is it no different than getting used to:

Death in the hospital?

Abortion?

Assisted death?

Trauma care in general?

Palliative care? Ah, palliative care!



Mixtures of fluids is tricky, surprising, potentially fatal.

(so you see, the trick is understanding data on your own terms)

Hypotension is bad for the injured brain.

But who pays the oxygen debt?

98,000 deaths a year from medical errors

Now, everyone is scribbling

Now on to child abuse

(as about 1/3 of the audience gets up and leaves the auditorium)

“The enemy of good is better” James C. Carrico, MD

Why don’t they listen to this guy?

Right and left do make a difference

The racemic mix just didn’t work as well.

But no one noticed.

Life imitates science.

Watching the young woman on the aisle

Tuck her bare feet under her bottom, comfy.



Antioxidants improve resuscitation outcomes

The age of the blood affects outcomes.

You don’t want old blood.

Gene-banger. What’s that?

This is a young man’s game, methinks.

If the gut works, use it.

Neuropraxia

Transient quadriplegia

Plexopathy

Nerve root injury

Funiculi

Foraminotomy

Transfusion-related acute lung injury

Platelets must be stored at room temperature, higher risk of transmission

No longer using plasma from females

Older blood-more likely to die—third speaker who says this!

Cryoprecipitate

Second impact syndrome

Lunchtime. I hate small talk, choose to take a walk rather than sit at a table with strangers eating hotel food. Am I an arrogant shit? Probably. But, trauma conference—focus is on war and sports injuries—why am I here? Would rather write a blog than talk. Arrogant shit? No doubt.

Trauma surgeons with their PP slides of bloody flesh, distorted faces, missing limbs–these bring pain into vision. But few outside this club can look. I suppose that I can sit with strangers after all, these comrades who can look at carnage, and then eat lunch.



Preventing ventilator-related pneumonia.

The ventilator bundle.

They look much better, after we place the trach.

Really cute speaker, little crush here!



Thinking about when I wanted to die for every misstep, every miscalculation, every misunderstanding. Now I don’t think about wanting to die,

because I know that I will soon enough. No matter what.