Tuesday, May 31, 2011

May 31, 1889




One of the worst disasters in American history happened today, and is mostly forgotten.

It was the Johnstown Flood. And unless you grew up in Pennsylvania, you may have never heard of it.

Johnstown, Pennsylvania had a population of 30,000 in 1889, and was growing rapidly due to the steel industry. Because of geography the area was prone to flooding, and so the South Fork Dam had been built to protect the city.

When the dam was built (1838 to 1853) it was considered quite solid, but by 1889 had fallen into disrepair. A group of businessmen had lowered the top of the dam to build a road over it, and occasional small leaks were patched with simple materials (like mud). The iron spillways (used to release water in order to prevent collapse) had actually been sold for scrap. Concerns had been raised about its safety several times, but, as always seems to be the case, nothing was done to correct them until it was too late.

On May 30, 1889 a HUGE rainstorm struck, dumping 10 inches (22 cm) of rain over several hours. Elias Unger, the president of a local hunting and fishing club, awoke the next morning to see the lake was almost to the top of the dam.

He quickly assembled a group of men, and, in the pouring rain, with the dam threatening to collapse and kill them, they frantically struggled to prevent disaster. Some worked at the top, piling muddy earth higher to raise its height. Others tried a create a new spillway to relieve pressure. On 2 occasions John Parke rode his horse to the nearest telegraph station, sending messages to Johnstown to warn them of the impending disaster. Both messages were ignored, as there had previously been similar false alarms during storms.

By 1:30 in the afternoon, Unger and his men realized that their efforts were futile, and disaster was inevitable. They gave up and retreated to high ground, and hoped that downriver in Johnstown their messages had been heeded.

At 3:10 p.m. the dam collapsed explosively.

20 millions tons of water from Lake Conemaugh were sent raging downhill toward Johnstown. As it poured down it picked up anything in its path, turning into a gigantic blob of debris. Trees. Homes. Barns. Farm animals. Boulders. It destroyed several smaller towns on the way to Johnstown, and a witness described it as "a huge hill rolling over and over". One small town of 40-50 homes utterly vanished, with nothing but bare rock left behind.

Locomotive engineer John Hess saved many lives in the community of East Conemaugh. He tied his train whistle down, and drove backwards toward the town, hoping they'd hear its screeching. Hess miraculously survived when he was thrown from his train as it was overtaken by the flood.

The flood struck the Conemaugh Viaduct- and stopped as debris blocked its way through the arches under it. But after a few minutes this structure collapsed, and the downhill torrent resumed. This brief stop, then resumption, actually increased the force of the water as it headed downhill.

Just outside Johnstown the flood became even more deadly. It hit the Cambria Iron Works, picking up buildings, railroad cars, factory machines, furnaces, piles of coal, metal plates, and LOTS of barbed wire- and added them to its swirling mass.

At 4:07 p.m. a wall of water and debris, 60 feet (18 m) high, traveling at roughly 40 miles per hour, struck Johnstown. Some frantically ran for attics, only to find the water was too high. Many were crushed or trapped by trees, barbed wire, and other debris that were part of the flood. A large portion of the town was utterly destroyed.

The Johnstown Stone Bridge (still standing today) partially stopped the flood's progression, as debris blocked the arches under it. Unlike the Conemaugh Viaduct, however, this held- and as a result a second flood wave was directed backwards at Johnstown, striking the ruined city from the opposite direction.

To make matters worse, the huge pile of debris trapped at the stone bridge (covering 30 acres and 70 feet [21 m] high) somehow caught fire. It killed 80 people who were seeking shelter on the bridge, and the flames quickly spread back into Johnstown, going to the structures that were still dry and standing. It burned for 3 days, killing many who had escaped the waters.

Two of the most courageous figures in the disaster were Hettie Ogle and her daughter, Minnie. Hettie was a Civil War widow, and she and Minnie were Johnstown's telegraph operators. As the flood roared down, Hettie frantically sent warnings to communities further downriver, saving countless lives. Rather than trying to save themselves the two stayed at their post, tapping out updates and repeated alarms until she sent "this is my last message" as the waters surrounded them.

All together 2,209 people died in a few hours. 396 were children.

800 of the bodies found weren't identifiable, and are today buried in a large "plot of the unknowns" in Westmont, Pennsylvania. An eternal flame is kept alight there in their memory.





The American Red Cross was only 8 years old, and had never handled a large disaster before. Clara Barton, its founder, personally led the efforts. She and her staff arrived in Johnstown as soon as they safely could (5 days later) and stayed there for 5 months. Their tireless work in such circumstances brought the Red Cross great recognition, helping to build it into the organization it is today.

None of the businessmen who'd owned (and neglected) the dam could be held responsible under the prevailing legal actions. American law was subsequently changed to make such people responsible for their actions, and the laws remain in effect today. It forever changed the American system of legal liability.

The stone bridge that partially stopped the flood still stands 122 years later, a grim reminder of the tragedy.



1889




2011

Monday, May 30, 2011

Today is a holiday...

And the kids are out of school for the Summer.

So, in lieu of a post, I offer this:

1. For Memorial Day, please check out some of the posts on my history page.

2. One of the best posts you'll ever read is over on ER Stories today. It's a MUST read.

I will return to my regular posting tomorrow.

Sunday, May 29, 2011

Life in the Doctor's Lounge

The doctor's lounge usually has some bagels and muffins every morning, and bread for toast.

Next to the bagels is a bagel slicer, which I'm sure you've all seen. It bears a vague resemblance to a guillotine.




This morning I noticed there was half a bagel in the slicer.

As I sat looking up patient info on a lounge computer, I watched 3 docs come in for bagels. They each took the abandoned half out (which sounded hard as a rock when they set it on the counter), slice their own bagels, THEN PUT THE STALE HALF BACK IN THE SLICER!

It was still there when I went to round. For all I know it will be there when I retire.

Saturday, May 28, 2011

Memories...




It was Halloween. Frank was 1 year old. The twins hadn't been born.

The trick-or treaters had come and gone. I was putting things away, when the doorbell rang again.

I probably shouldn't have answered it, but figured we still had lots of candy, and were better off getting rid of it. So I did.

It was 2 guys. Both wearing pillow cases over their heads. Both with their hands out of sight. They said nothing. One started reaching into his jacket pocket.

Before I could slam the door, Blackdog suddenly lunged out of nowhere, growling and barking. She'd placidly laid in the hall and watched one group of trick-or-treaters after another, without moving. But now she was suddenly out for blood.

The two guys bolted and ran as she came for them. I grabbed her collar and slammed & locked the door.





Thank you, Blackdog, for everything. Your amazing 16 year run of devotion came to a peaceful end last week, and we will miss you.

Thank you for always watching over (and putting up with) us.





You've earned your rest, my furry friend. See you on the other side.


Friday, May 27, 2011

Neither the first nor will it be the last...

Dr. Grumpy: "Are you allergic to any medications?"

Mr. Unsure: "A pill once gave me a rash."

Dr. Grumpy: "Do you remember what it was called?"

Mr. Unsure: "Nope. Can you name some medicines? I'll tell you if it sounds familiar."

Today's helpful hint: Finding a doctor


People often ask me "How do I find a good doctor?"

That's a tough question, and it can be tricky. So here are a few tips to warn you that your doctor may not be real. Any one of these (not to mention ALL of them, FFS) should alert you to look for another doctor.


1. A reputable physician's sole listing will likely NOT be in a Bulgarian language newspaper in Skokie, Illinois.

2. A reputable physician generally will NOT be seeing office patients at 6:30 on a Saturday night.

3. A reputable physician will NOT wait for you, alone, in a dark, locked, building with a "CLOSED" sign in the window.

4. A reputable physcian will NOT let you knock for a while before letting you in himself.

5. A reputable physician will NOT stick toothpicks in your chest.

6. A reputable physician will NOT give you a bottle of pills labeled "Prosperous Farmer" that expired in 2002 (or anything called that, no matter when it expired!)

7. A reputable physician will ALWAYS have some sort of office paperwork.

8. A reputable physician will NOT jump into his car and try to drive away when you return for a follow-up visit.


If your physician does this, and you paid $150 cash for it, then you must have been seeing this guy.

And, for the record, I think it's absolutely pathetic that the patient involved didn't see a problem with items #1-6.

Thursday, May 26, 2011

Afternoon interlude

Between patients today I went to talk to Dr. Pissy. He was in his office, calling his father on the speaker phone. Pissy's family lives in a fairly remote area, and I got to hear this:


Dr. Pissy: "Hi, Dad, how are you?"

Pissy Senior: "I'm working".

Dr. Pissy: "What are you working on?"

Pissy Senior: "Cleaning a 'possum."

Going in circles

Dr. Grumpy: "How often do you get migraines?"

Mr. Vague: "Every so often."

Dr. Grumpy: "Well, how much time goes by between headaches?"

Mr. Vague: "A while."

Dr. Grumpy: "I'm trying to get an idea of how often you get migraines. Can you be more specific? Do you get them every day, or every week, or once a month?"

Mr. Vague: "Sometimes."

Wednesday, May 25, 2011

Mary's desk, May 25, 2011

My 10:00 was a new patient today, a lady in her 60's. At 10:03 her daughter showed up, and had this conversation with Mary:

Mary: "Hi! Where's your mother?"

Mrs. Daughter: "Oh, she'll be here. She had a lot of errands to run, and won't get here until 10:30."

Mary: "Her appointment is now, not 10:30."

Mrs. Daughter: "I know that. It's why I came in on time. I'm holding the slot for her."

Mary: "Excuse me?"

Mrs. Daughter: "I'm here, since she can't be. I'm holding the slot, so you won't cancel it before she gets here. She'll be here at 10:30, I promise, and in the meantime I'll wait here in her place."

Mary: "But you're not the patient!"

Mrs. Daughter: "What does that have to do with it? I'm here on her behalf."

"This has RUINED my manicure! IT'S VERY SERIOUS!"

The emergency room is staffed to handle a lot of things. But, unfortunately, most don't have a 24/7 manicurist available.

Like this lady wanted.


Thank you, Lydia!

Tuesday, May 24, 2011

Hunka hunka burnin' love!

A nurse at Local Hospital is getting married soon, so they had a shower at work for her yesterday. One of the gifts had been left out by the desk where I was writing in a chart, and I glanced it over.

It was a small bottle of "chocolate flavored body paint, for intimate moments". On one side of the bottle it said "before using, light candles for a romantic mood."

On the other side it said "Warning: Flammable. Do not use near open flame."

Monday, May 23, 2011

Another satisfied customer

Mr. Shakes: "This is my last time here. I've decided to find a new neurologist."

Dr. Grumpy: "May I ask why?"

Mr. Shakes: "Because I didn't have Parkinson's Disease before I came here! Then you told me I have it, and now I do, and I don't like having it! It's your fault!"

Idiocy abounds

Last week I renewed my subscription to my favorite journal "Neurology and the Art of Sarcasm". It was 3 years for $400 (that, believe it or not, is considered to be a good deal).

So I sent them a payment for $400.

On Saturday I received a box containing the last 3 years of issues (which I already have), and a letter asking me if I'd like to subscribe to the next 3 years for another $400.

Needless to say, I'll be calling them this morning.

Sunday, May 22, 2011

It's that time of year again

I've been reminded that USMLE part 1 is fast approaching. So I'm reposting my own memories of the test.

And this clip, from the movie "Real Genius". In 30 seconds it summarizes perfectly what studying for USMLE is like.






Anyway...

At the end of the second year of medical school is the USMLE-1 (United States Medical Licensing Boards, Part 1- the name is misleading, several countries use it). This covers every subject from the first 2 years of medical school: Anatomy, Biochemistry, Pathology, Pharmacology, Microbiology, Neuroanatomy, Physiology, Histology, and a few others. 2 years of learning, all in 1 awful test. When I took it the test consisted of 4 sessions spread out over 2 days. Each session had 200 questions, and 3 hours to answer them.

At my school, if you failed the test, you had to take it again. If you failed it twice, your medical career was over (though you still owed your student loans back).

It was the Summer of 1991.

I don't remember the specific dates. But basically, between the time med school ended for the Summer, and the dreaded test, was roughly 1 month. You had 30 days to re-study everything that had taken you 2 years to learn to that point. And pretty much your chances of a career in medicine depended on how you did.

So it was stressful. And, to this day, I still feel for all of you who are out there studying for it now. Any classmate, resident, or attending who tells you they weren't scared is lying.

Within hours of the semester ending, my class had gone into hiding.

I stopped shaving, to save time. My roommate, Enzyme, disconnected our TV, moved it across the room, and piled furniture in front of it.

My days consisted of me getting up at 7:30. I'd either stay at my apartment desk or walk over to campus to find an empty classroom to study in. I'd put in my trusty earplugs and the world around me ceased to exist.

Around noon I'd go back to my apartment for a PBJ, then go study again. At 5 I'd go back to my place for a sandwich, or ramen soup, or Rice-a-Roni. I'd sit out on my balcony and eat, for 15 minutes of relaxation. Or I'd read a book with dinner (Enzyme and I were both reading a single copy of "The Price of Admiralty" by John Keegan. It sat on our kitchen table for the month, and we'd have different eating times so we could share it). I never spent more than 30 minutes on a break. After dinner I'd go back to my desk, or campus. I'd study until around 3 a.m., then go home to sleep for a few hours.

I called my parents a few times. My daily outfit consisted of gym shorts (the short kind, from the 80's), T-shirt, sneakers, and the growing beard. Days blended together. There were no differences between weekends and weekdays. People I encountered were superfluous to my existence. I saw my classmates a few times, and we exchanged glassy-eyed nods as we passed.

I shaved a night or two before the test. I studied until around 11:30 p.m. on the eve of the test, re-reviewing a few last points.

It was weird, like I was living alone on another planet for 30 days. I have no idea what happened in the news that month. I was out-of-touch with everything but my books.

If there's one thing I came out of medical school with, it was this: The realization that there was absolutely, positively, no way you were EVER going to get everything read, studied, and reviewed that you needed to before the test.

And, somehow, when the test was over and the dust had settled, you'd done it. And you'd have no idea how. I still don't.

Good luck, everybody.
 
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