Hero to goat

Today three of my patients discharged to hospice. Another died in the hospital. I saw one person with a broken arm and dislocated shoulder. Finally back in my element, I was able to help someone; someone who is going to go home, get outpatient therapy, get better, go back to work. This is what I like about trauma and orthopedics – I have useful skills to offer and my patients get better.

It was only a few days ago that hospital workers were being hailed as heroes. Now we are surplus labor. Due to the uncertainties of the novel coronavirus and questionable planning by senior management, I will soon be out of work. The press release said that senior management would take a temporary 20% pay cut, middle management 10%, and hourly workers would see no cut. A nurse manager informed me that the CEO’s salary is $1.7 million. I am unable to verify this. If that is correct, his reduced salary for 8 weeks will be less than $210,000 – how anyone can be expected to live on that, I don’t know. What didn’t make the press release hit the fan the next day – a 33% cut in hours for hourly employees, with a “choice” of how to take the hit. Two and a half weeks without pay in the next eight weeks. (An update referred to this as “non-requested time off”.) (Like everything else COVID-related in the hospital these days, this could be inaccurate by the time you read it.) If my retirement funds hadn’t taken such a hit this winter, it would be Johnny Paycheck time:

One of my co-workers said she came down with “anal glaucoma – I can’t see my ass working here anymore.” The hall monitors asked the usual: “Self-monitoring? Any new symptoms?” I said, “Yes, I’ve come down with new symptoms – a deep disappointment in, and resentment of, senior management.” She checked the list and said that wasn’t on the list of symptoms, so I could go to work. My daughter in law pointed out that this was actually an acute exacerbation of a pre-existing condition – “he’s been presenting with disappointment in and resentment of upper management for quite some time”.

Another Modest Proposal

President Trump announced his desire to study the effect of injecting or ingesting bleach, rubbing alcohol, or other disinfectants to treat COVID-19.

He may be onto something here; he just didn’t think it through all the way. In related news, hundreds of people crowded onto the state capitol grounds in Madison WI (as they have at other state capitols this week) to protest the governor’s “Safer at Home” order and call for the immediate “re-opening” of the state. This seems like a natural population on which to test my hypothesis.

What if, instead of treating COVID-19, we were able to prevent it? My hypothesis is that 100% of people treated prophylactically with injected bleach will not contract COVID-19.

We would first have to test all of the protesters to ensure that no one is already infected. That would rule them out of the study. We could divide the remaining protesters into an experimental group, to be injected with bleach, and a control group, to be injected with normal saline. We would then measure the rate of infection with COVID-19 after 2 weeks and after a month. I hypothesize that none of the experimental group will be found to have COVID-19 on either of those tests. [Editor’s note: the author further hypothesizes that none of this group will live to the first follow-up, and will die of other causes, but that is not the dependent variable we are studying here.] Granted, this is a convenience sample and not necessarily representative of the general population, but some might argue that is actually the beauty of it.