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Sunday, June 29, 2008
Reasons I'm Leaving Emergency Medicine (number 9)
I believe my Deb has a lot in common with the real Dr. Peel... an overblown sense of her own importance, a barely buried contempt for masculinity, and a boatload of guilt and remorse from sources unknown (but which, probably, have to do with the ever-dawning realization that the career she chose over family will not be all it was supposed to be).
Deb got drunk one night at a conference all us senior residents attended. It was 3 in the morning and my wife was with me at a little pizza joint. We were all drinking beer and having a blast. We had just come from one of the last drug-company boondoggles I will ever see, with open bar and super food and music at a very posh venue. We had a blast (ever since that drug company function I have only prescribed their medicine... for everything).
There were about six of us around that table when Dr. Deb said to me, one drunk to another, "You know 911, you need to treat your wife better" (my wife was sitting right there and heard the whole thing).
"Huh?" with quizzical look and waiting for the punch line.
"You walk around like you're some kinda big-shot and you don't deserve to have your wife and you are not a bigshot and everyone thinks you're an asshole," said Dr. Deb.
This was not a punchline. I was stunned. I left with my wife and we went to the hotel where she tried, unsuccessfully, to convince me that I was a good husband and a good doctor and that Dr. Deb had been drunk and crazy to say what she had said. For the record I only beat my wife when she deserves it and only with my non-bowling hand... I usually remove the all my rings too. I later learned that Dr. Deb spent the rest of the night trying to seduce a fellow resident who was 12 years her junior. Classy.
I was so upset by this that I went to the program director and asked if the rest of the attendings felt about me as Dr. Deb did. "No", he assured me. He then wrote her statement off for reasons having to do with her life outside medicine (pending divorce, screwing one of the nurses etc...), and they did, in fact, graduate me on time and with honors.
No matter, I couldn't get over it and avoided most contact with the bosses after that. 8 months to go in residency and I shut my mouth and tried to let it die.
Dr. Deb offered an apology of sorts at the graduation party she had at her house. The apology was in the form of a joint... I declined.
52 comments:
One can only hope Dr. Peel's nipples fall off during the throes of passion.ReplyDelete
- pedimom6:46 PM, June 29, 2008
911 - What a stupid bitch she was/is. For what it's worth, the times I have had the pleasure of being around you and your wife/family, you have impressed me. You are a thoughtful, kind-hearted, funny, incredibly intelligent human being. You can take care of me and my family anytime. Hugs! Wife O' CatReplyDelete
i was hoping someone would use that word because in this case it fits. pedimom, you are the best... you just made my night.ReplyDelete
That is a horrible thing to say. Also how is your relationship with your wife anyones business? In polite society it is not appropriate table conversation. My Mother would say that she was probably jealous of your relationship and therefore was acting out. My Mom spent most of the 70's and 80's reading self help books.ReplyDelete
ANd if I was residing in your brain, I would say "Wow, what a F-ing Douche bag!!!!
- Anonymous7:33 PM, June 29, 2008
"He then wrote her statement off for reasons having to do with her life outside medicine"
A true professional does not let personal problems influence behavior in a work-related environment.
I do believe that what goes around eventually comes around. It will catch up with her. What an idiot...
You are such a considerate person. I mean, not all men would think of removing their rings first. I am sure your wife knows how lucky she is. :-)
- Anonymous8:13 PM, June 29, 2008
If you want to keep that bowling hand safe, keep the pimp hand strong...ReplyDelete
pedimom / catwife: are we talking about the same person? maybe you have a closed head injury suffered concurrently with the ankle break ;)
911: i hope you said something offensive about female genitals and had a drink thrown in your face. dude, is this fucking cunt related to our associate dean of students? they sound like the same fucking miserable slag-whore.
You had me until you turned down the joint. Attendings probably had the good stuff, not that Mexican schwag.ReplyDelete
related? only in worldview. 'cat, it probably was fine northern california sinsemilla. she had a patent on it, mixture of kentucky bluegrass, featherbed bents, and n cali sins. the great thing about it is you can play 18 holes on it and then come home and get stoned to the bejeesus belt smoking it. cannonball coming... it's a bit harsh.ReplyDelete
- Anonymous8:24 PM, June 29, 2008
Maybe not related, but the similarities with, well, let's call her "Dean Peel", are scary. Like, as in, secretly despising you for several years and wanting you thrown out of residency / med school if possible... maybe this is a story for another day.ReplyDelete
obtw lynn,ReplyDelete
enjoying your book. readers, lynn price has written a good book. it's worth a buy and a read. she is only paying me 1$ per referral so it's not like i'm getting rich or anything. and based on the crap i have read and not finished lately (shockwave by clive cussler, and some atrocious POS just like it this is a keeper). just click on her link and you can read about the book. it's not all hippy or anything and is an especially good read for romantic comedy fans with an interest in medicine and alternative medicine.
are you referring to the woman named after a person from a specific country?ReplyDelete
lynn price has written a good book.ReplyDelete
Aw, 911, you have me blushing here. And what would my character, Kim, think of that? She'd probably kick me in the ovaries (if I had any) and tell me to widen the doorways for my fat head. Seriously, dood, thank you. Coming from a doc, I'm really touched. Or is that tetched?
- Anonymous8:56 PM, June 29, 2008
Must your books be read in the order they were written or does it not matter
Which one are you reading now?
donovan's paradigm. kim donovan md, totally hot.ReplyDelete
- Anonymous10:04 PM, June 29, 2008
Hey 9-11 I can gather Deb probably wasn't a hottie, but was she even potentially do-able? Because I think she wanted some of your one eyed Georgia Trouser Snake. The XX residents at my program were mostly affirmative action graduates who went around getting offended by various things like used condoms in the call room.ReplyDelete
she was potentially do-able if you like handsome men. she definitely had a huge chip on her shoulder. i think women make great doctors but i do think there is a subset who put off the family decision till they are halfway through residency and then want desperately to get married and have kids. the more 'modern' they are the less likely they are to plan for this ahead of time and choose a specialty based on this. how many happy female surgeons do you know? how many men would not be intimidated by being a working-stiff married to a hotshot surgeon? it would scare me to death and make my penis shrink down to 8 inches.ReplyDelete
Yuck! It's obvious, she just wanted you. In some weird demented way.ReplyDelete
- Anonymous6:03 AM, June 30, 2008
I put off the family thing for awhile until I ran into that defective condo- umm beautiful girl who caught me in her web. I'd love to be that guy, running the Mercedes to Jiffy Lube, the Poodles to the Doggy Spa etc.ReplyDelete
I know of one female general surgeon who is married to a very nice man who does not seem to be put off by her success. SHe is my Sister in law. And her kids are all really great kids who are well behaved. My brother in law stays home to be MR. Mom and get them to all the stuff kids do these days. For them it works out well. Next time I see him, I will ask him if his penis has shrunk.ReplyDelete
911 she had the hots for you. Very obvious. Why else would a woman try to put a wedge between you and your wife.ReplyDelete
What a bitch indeed!
Must your books be read in the order they were written or does it not matter
Amy65-c, there is only 1 book out right now - the one 911 is reading. The second one is in the works.
Really sorry for the hijack, 911...
- Anonymous9:13 AM, June 30, 2008
Good story - but.....why is this a reason you are leaving emergency medicine?ReplyDelete
After all - this occured before you officially entered it & you seemed to have weathered that storm, both maritially & professionally.
Are you still so upset over this encounter you must run from it in real life as well as in your memories?
Seems to be more going on there than is being said?????
- pedimom9:29 AM, June 30, 2008
etotheipi - yes, pedimom/wo'cat would be the same idiot who drank too much wine at your rehearsal dinner and fractured foot. Man, I was hoping that had slipped from your memory. What a fun weekend, though (minus the fracture and a cussing Cat who had to handle all luggage and a wheelchair w/me in it at the airport- he swore he'd never take me anywhere again!)Thankfully, he lets me out of my cage on occasion.ReplyDelete
Hey a question for an anonymous doc. Please.ReplyDelete
I think I just broke my pinkie toe. Holy crap my pain is a 10 out of 10 and I need to go weep and wail and gnash my teeth at my local EMR. Just kidding.
Ok seriously though, I don't need to do anything but take tylenol right? I caught it on a suit case. It's not deformed. It's the first pinkie toe joint that hurts, the most distal joint. Nothing to be done I'm sure, but whine right? Should I stop exercising until it's better?
Buddy tape the last two toes, ice, and motrin ( or dilauded if you have some) Will heal in 3 or so wks if toe be broke.ReplyDelete
Sweet! Going to make myself a dilaudid on the rocks!ReplyDelete
Thanks Cat!
Hey ya'll Texans out there, does anyone know about living in San Antonio? Safe places to live there?
dear anon,ReplyDelete
good question. refer to post on reason ten and same question asked there. dr peel ends up not being an outlier but a common personality in medicine. one of the reasons i went into medicine was that i thought, when i was a child, that the best group of folks were doctors. it certainly WAS true when i was growing up... then i went to law school and found out that in a class of over two hundred that i found very few folks to like. medical school was different. i had a fantastic class of great people, maybe three or four of whom were very up front about wanting to make as much money as possible. the faculty, with rare exception, were the embodiment of the ideal physician. BUT, from residency onward, i have been perpetually disappointed. that is not to say there aren't fantastic doctors who are also fantastic people, but i seem to have a knack for finding the bad apples, or, more likely, because i'm outspoken, the bad apples seem to find me. more to follow.
I had the same question my dear friend. There are assholes in every profession. I was hoping our colleagues were not one of the reasons for you wanting to leave ER medicine.ReplyDelete
Question: Do you think the quality of people entering medicine has changed or could the challenges of practicing medicine today be contributing the attitudes you are seeing?
i don't know whether the quality of those going to medical school is decreasing. it would seem logical that medical school would now be unattractive to many folks who are independent thinkers and desirous of a career outside bureaucratic dominance. i think you would have a better insight than me here. i DO think that surgical and medical subspecialties are not filling their fellowships and i think the reason is obvious. i maintain that the REAL crisis in medicine in five years is not going to be a primary care crisis, but a surgical crisis.
i don't know whether the quality of those going to medical school is decreasing. it would seem logical that medical school would now be unattractive to many folks who are independent thinkers and desirous of a career outside bureaucratic dominance. i think you would have a better insight than me here. i DO think that surgical and medical subspecialties are not filling their fellowships and i think the reason is obvious. i maintain that the REAL crisis in medicine in five years is not going to be a primary care crisis, but a surgical crisis.
I haven't heard of an impending shortage of internal medicine specialists or surgeons. Certainly, lower-paying medicine specialties like endocrinology are having a difficult time finding anyone to spend 2 more years training with no more income than most primary care doctors. Most endos you will meet out of training over the next decade will be foreign born and trained.ReplyDelete
We graduate 25 internal medicine residents a year and less than 5 go into primary care. They are going where the money is...GI, cardiology, pulmonary critical care, or hospital medicine where they do shift work essentially.
in the last match vascular surg filled 75% and 25% of those were foreign trained. CT surg filled 60%
I stand mistaken.ReplyDelete
Primary care crisis.
Surgery crisis.
Endocrine crisis.
Let's hope you don't show up needing your pituitary gland removed urgently in the next decade! Ha!
- Anonymous6:37 PM, June 30, 2008
I went back over those comments from reason #10 since you pointed out your reasoning was the same.ReplyDelete
Forgive me, I'm trying to follow. It seemed as though that rant went back & forth "the old way was better", "no this way is better", no "a compromise is better".
Now, the discussion turns toward younger physicians coming in compared to when you entered, which appears irrelevant in this situation since your good drunk Dr. Peel was your colleague & of "your era" so to speak.
But, a few of your comments seem to stand out. First, you went to law school and didn't find many to like, although you were in a large class - oddly, you never made a comment on the work you were exposed to or might have done within law - just the people.
Now, you enjoyed your medical class, but not your residency class. One could wonder it might have been the smaller class, although the smaller number of people in residency were more objectionable. One could wonder that medicial school in & of itself is a rare course of education which combines didactic work & clinical work in a setting you won't get anywhere else (coming from my experience & that of my offspring who is just about to finish).
So - now one wonders & you do yourself since you pointed out perhaps you just attract bad apples. Rather than attract bad apples, perhaps you don't find satisfaction in the "stagnation" which comes with spending decades in any one career. I don't mean stagnation in the sense that nothing ever changes, but each of us must go in day in and day out, night in and night out. You see the rare thing you've not seen before on occasion, but for the most part, you've been trained well & can sort out most all medical problems presented even when not presented just the same. But - it is still emergency medicine - not trust law, nor trying to write new computer program, nor trying to market a new style of snowblower....or any other jobs thousands of others have which don't change tremendously once you've become good at it and been at it long enough.
You found emergency medicine, perhaps partly to keep that constant toss up of patients, changes in acuity and exposure to all sorts of medical and surgical issues.
However, you don't seem happy and you hold on to these apparent "slights" or bruises to your ego from long ago. No one can tell you other than you that at some point, you let some things just go and if you don't they'll wear you down from inside. Dr Peel is probably practicing somewhere & she might even be happy. Would that make you unhappy to know that?
I'm as old as Old Fart and I'm wondering if its you - not the system, not the new physicians, not the patients, not the administrators or insurers.... Medicine is and always has been a career of change. How we handle things clinically changes and the cirucumstances under which we practice changes - it always has - sometimes for better & sometimes for worse. But, the one thing you can count on is - change.
Perhaps it IS just you and being unhappy with where you are with life. Not unusual & certainly not unreasonable to want to change what you do for a living to find happiness. People change jobs, towns, spouses all the time for just that reason. Absolutely nothing wrong in that!
But - Dr Peel was not the reason. Sadly, you've held onto this story. On first read, it was oddly funny. Now its just sad - and not for Dr. Peel.
Best of luck in finding that elusive thing that has no pulse, can't be seen on imaging or in lab work. But, when you don't have it, you & everyone around you knows you're no longer happy. When you are, there doesn't seem to be any one reason why. Odd....
Out of curiousity - does Mrs. 911 remember much of this story? I'm also waiting to see reasons 1-8. They'll give more insight perhaps.
at last dr peel comments on my blog!ReplyDelete
thanks anonymous, for the monday morning quarterbacking and dime store psychoanalysis.
believe it or not the first thing that occured to me was that I was the problem. i may be.
also, i think that if you continue to follow the series that the higher numbered reasons will be more to your liking and more indicative of issues that plague the whole of medicine and modern society.
angry? yes. bitter? yes. quitting? yes. giving up? no.
mrs 911 may choose to put her recollection of the events mentioned here. i will ask her to.
as far as law goes here's the short version as i lost the long version in a mysterious blogger glitch...
i chose law as an 'out' from medicine which i saw, at the time, as being too much for me to handle. ultimately the desire (my 'calling' to medicine if you will) overcame my rational choice but there's more...
in law i met, not people in pursuit of the eternal, but people willing to think very uncritically and pore monotonously over the latest judicial hijaking of our legal system by activist judges.
my summer clerkships, which i approached with the attitude of 'well, law school may suck, but now i'll figure out what the practice is all about' were worse than law school.
the under the table power-plays and back-assward reasoning all done in pursuit of the billable hour were repellant to me. it also became obvious fairly quickly that the partnership track, at least with the large firm i was with, was replete with land mines and not for plain spoken folks like myself with a short fuse.
enter medicine. a touch of the eternal, a touch of God, the ability to be the one who holds the line and make a real difference, now, with objective and changing, but not nonsensically changing, truths.
from day one in medical school i was with my kinda folks. as opposed to a few friends in law school i made friends, within the first few weeks, who are still some of the best people i've ever met. you may have read some postings from some of them.
enter emergency medicine. right up my alley. what's important now? what's the right thing right now? i'm good at that. peds to geriatrics to psych to OBGYN i'm the guy that can take care of you for the first few hours.
lives saved? many. lives lost. many. bad news delivered? a lot. good news delivered? a lot. important? i think so. the most important thing i can do? probably. a calling? yes. a career? unfortunately for me, and, i like to think, my patients, no.
to get back to the point of this post, the reason it is not going to end up being a career, is that dr peel and dr spanz are legion. they are already in positions of power and their clones are multiplying.
doctors surrendered their territory to a bunch of non-clinicians the minute they said 'yes' to medicare/medicaid and fee for service was buried.
no, i am not arguing for a return to fee for service, but i am arguing for a return to health care as a privelege and not a right. a system where you pay what you can, not nothing, for your care. a system where (shudder) decisions affecting patient care are made by (shudder) me, or another physician practicing in the ER.
the decisions that directly impact patient care and outcome today are made by clipboard carrying putzes who go to bed at 9 every night and come in bright and cheery every day to tell me how to do my job better.
if i thought this would change anytime soon then i would stay. but the fact is, that me pointing out the problems gets me nothing but trouble.
example, suggesting at my last facility that we have signs in the waiting room encouraging our spanish speaking only patients to bring a translator with them got me branded 'racist'. suggesting that people actually pay something for their care is laughed out of the building while bills are inflated and people are overcharged to make up the shortfall.
meanwhile my lobby is all atwitter about the proposed cuts in medicare funding. our livelihood, now, depends on the government, and aside from a few of here and elsewhere, we are going to smile and be grateful that the government deigns to not cut our pay.
the time is ripe for an entrepreunurial type to open a clinic that gives great service for cash. it will end up happening anyway and the wealthy will still get great care. meanwhile, absolutely BECAUSE of EMTALA and ridiculous tinkering from legislators and groups who demand, and demand, and demand, the care for the general populus will suffer.
so. ER? great fit for me. layers of beaurocracy with nincompoops calling the shots? terrible. i did this to be the boss in my little area. i am not. i will never be the boss in the current system even within the walls of the ER.
the thing that drives me crazy is the thought that this is NOT the way it was forty years ago. hence my longing for 'the way it was', whether that is based on a clear view or not is, well, unclear.
taking my ball and going to play elsewhere.
- Anonymous8:34 PM, June 30, 2008
Comment from Mrs. 911ReplyDelete
Dear Gentle Readers (don't you just love Mrs. Manners?);
I've tried to stay away from this battlefield blog but my presence was requested for some interesting questions by anon. So here goes...
Yes, I do remember the night in question (at least I remember THAT part of the night, although the rest gets a little blurry). Those comments were made and she was as drunk as the rest of us.
Does that excuse her comments? Certainly not, 911 had never "asked for it". She's lucky she's a girl, since the last person to have made a comment like that promptly got a fist in the face afterwards (another large bash, maybe 911 is an easy target for loose-tongued drunks?)
I think that anon asks some interesting questions, but I will tell you that 911's places of employment are straight out of Orwell's 1984 with doublespeak and all.
The administration of the "hospital" requested that employees stop sending emails because "they were tired of hearing complaints from all over the hospital".
I've got nothing against ostriches, but perhaps the head-in-the-sand approach might not be the best way to fix an understaffed, overworked facility.
Strangely, they've had a difficult time retaining physicians and nurses! Go figure.
On that note, anon, I just heard about a pediatrics nurse who has been working on the floor for 30 years who just quit. She simply could not take the dangerous environment that defines our local hospital. Today the telemetry floor had 8 patients and 1 poor little nurse who was taking care of all of them.
It would have been at that point I would have quit. Last year, our assistant CEO was heard to say, when the CCU was at critically low staff with full unit over the weekend, "Well, no one DIED, did they?" Are you kidding me?? That's pitiful and sums up the uncaring, dangerous attitude of people who don't know better.
Thanks for the invite, 911. You are a well-endowed, handsome young thing! By the way, your wife-beater T's are clean.
Mrs. 911
- Anonymous10:14 PM, June 30, 2008
Dear Dr & Mrs. 911,ReplyDelete
So glad you both showed up to the party this evening (morning???).
It shows an interesting side of both of you! Mrs. 911 - you recall the evening, but from your point of view, what does any of that evening have to do with what is occuring right now in the environment your husband works?
Honestly - I have no judgement at all of your choices - they are difficult & have taken years to come to, I'm sure.
I, like you, left jobs due to staffing & what I've felt were critical issues in which I felt trapped. There were days when the only way out was "not to kill someone that day by my negligence or being overworked" - I think I said that very thing when I left my last job and I announced my decision to my spouse.
However, there are alternatives - and you seem to have found some Dr. 911. I've actually had to use services similar to what you describe when I had to take my 89yo mother to my brother's funeral. He passed away at 59 after a valiant fight with prostate cancer. He was a lawyer - but not one you describe.
He chose to take the underdogs fight - he had a small practice with 2 others & fought for those who had little, but who had been oppressed. He did not worry about billable hours & a partner track. So - he never made tremendous amounts of money, but- he was happy.
When he died, there were hundreds at his funeral. He was well liked by many, although an adversary to most. However, he had respect - and that itself brought him happiness.
Sadly, on the way to his funeral, my mother fell and scraped off the top layers of her leg - on warfarin & I'm in a different state...you know the rest. She WOULD NOT go to an ER because this was what she had to do, so I did what I could do with what I had available. My brother had physicians as friends (obviously - he had undergone many, many rounds of chemo - so I had access to those who could intervene and who were there and availble. But she would have none of it. Dignity brings with it its own problems).
However, the day later, we went to an urgent care clinic and there was a very nice urgent care physician who kindly gave advice, but couldn't offer more than bandaging & mupirocin and to see her PCP when she got home (she has not!) since so much time had lapsed - very appropriate.
So - there is a place for you. He charged $75, she paid by credit card & was reimbursed 1 month later by Medicare. Yep - you can do this - see little old ladies from out of state with scrapes, up to date tetanus & on their way home.
But - think long and hard - is this what you want? Is this the only way out for you?
Is there any way you can think to work within the system of emergency medicine to obtain the changes you seek and desire? If you're in a small town - no. You are sunk. And realize - if you've made enemies among the medical, nursing, pharmaceutical business within your town, you are sunk as well because they become referrals.
I cannot comment on your hospital - I don't know it. However, I do know that within hospital administration, there will be a tremendous shakedown of borderline profitable operations. Yours may be one of them. If Mrs. 911 is correct and you are living in an area of Orwellian double speak, then - move! Why live in such a backwards area since that mindset infuses everything - healthcare, education, city funding - even what you might seek - zoning and licensing!
Mrs. 911 - I can appreciate a hospital being flooded by employees sending complaining emails (does anywhere even allow this???) - those should all be routed via their supervisorial chief and dealt with at the administrative level. Each individual should not be able to flood an administrators email - that then becomes spam and not productive. There is a process and way to make changes & you either work within the system - or leave - just as you've both chosen to do.
However, I must disagree Dr. 911 - I live in one of the most multicultural and multilingual states there is. We do not insist the patient bring a translator (how in heaven's name can you even expect that in an urgent situation??). The telephone company will provide translator services for free - utilize it!
I guess I'm suggesting - this change will not solve your problems. Both of you are still upset over Dr. Peel's poor behavior at a drunken party. Both of you can get over that (yes - dime store analysis) and move on - or not. However, both of you still place "blame" on Dr Peel & her "ilk". What does a drunken resident bash have to do with anything in 2008 with regard to politics and medicine?
Your healthcare dime, mine and the whole country's healthcare dime is now very, very scarce. When I had no choice with my mother, I was willing to take her to an Urgent Care center - but, we were the only ones there. That was very "telling" to me! I would be money there was a wait at the ER. It did occur to me to wonder how an urgent care guy could pay for the overhead of that operation....
Do you want to see just those that have sore throats, think they're pregnant, scraped shins on warfarin? Is that your choice?
Or - can you find it in your very educated self to find a way to work WITHIN the system? Perhaps not since Mrs. 911 supports your decision. But, you have legal knowledge and medical knowledge. From my perspective, it would be wasted doing stat strep cultures or flu clinic lines in the fall.
Sadly, I think you might find your years of practice ahead just a bit more than boring and slight less profitable since the more advanced ED's are adding Urgent Care to their model to take the load off ED & to change billable hours to an outpt model. These will be your competition. I'd choose a hospital based Urgent Care in a heartbeat before one with a shingle with Dr. 911 - I don't know you, but I do know your hospital must abide by some rules. I also know what my recourse is when they don't! But, plenty of physicians fly under the radar - I know them well!
Still - I appreciate both your inputs and look forward to hearing reasons 1-8. Thanks Mrs. 911.
But - I don't appreciate the reference of me to Mrs. Peel - was that really necessary? Is that what gets you into trouble? I am old - yes, but not yet dead.
All the best with your choices! I hope my offspring does not become this jaded, since this has been the only choice my child was ever interested in since said child first started on this journey - and it is a journey - not a destination.
Happiness is a choice - not a given. Thats my only point. If your happiness lies in doing the urgent care model - I wish you all the best!
Your druken Dr. Peel did not affect that. You ALLOWED her to affect that and still do - see the difference?
dear anonymous,ReplyDelete
more tomorrow, but hey, you came here and offered advice so if you come off like dr peel to me then i call it like i see 'em!
urgent care would bore me to tears but right now i'll take bored.
finally and again, more tomorrow, it is precisely the turn of american society towards 'rules' or 'procedures' or 'protocol' for answers that results in the mess medicine is in right now.
doctors are fully trained, exceptional experts in their fields. the answer, to most question in the ER and ALL questions regarding care of patients are best answered by us, not the government or clipboard people and not by protocol or process. protocol and process are for non-experts.
i say this fully understanding the utility and necessity of laws and the rule of law, but show me greatness and great acheivement without a personality behind it... iow, something created by a bureacracy that is GREAT, and i'll take a look.
and by the way, i agree that dr peel didn't do this to me, again, dead horse, i chose these drs as examples of a type... a type that migrates to the top of huge human factories... a type that used to be shunned in medicine and is still shunned at the hightest levels no matter what field you are talking about.
someone, somewhere, sometime has to answer for decisions. i am ASKING to be this person in my little world. i am asking for the buck to stop with me, but the only place it does is when i'm a defendant in a malpractice action, an action made more likely by people with clipboards, people with the legislative pen, politicians, and folks who CHOOSE to ride on the backs of others.
Don't leave emergency medicine, 911! Check out our hospital first...Fully staffed, working equipment, specialists always reachable, good payer mix, get to leave on time, hospital-paid insurance, incentive pay for seeing more patients and not being layzee, and only a few real tools to deal with. Optional side-jobs in rural areas included. Not sure if we're hiring per se...but...ReplyDelete
Anon, I think you missed the point. Dr. Peel isn't the reason. I believe that she is an example, an archtype. It's not that one incident that you so doggedly keep analyzing, it's a case in point.ReplyDelete
At least that's how I'm reading it over here in layperson land.
Nice to hear from you Mrs. 911.
- Anonymous12:46 AM, July 01, 2008
I appreciate the banter Dr.911!ReplyDelete
Have a chat with Dr Oldfart. If he is truly as old as I am, he can remember the early 70's - perhaps the "peak" of hospital care.
We called the shots, we determined when the pt was ready to leave - not a social worker, an insurance monitor, a nurse case manager - NOPE - it was all US!
We arrogantly insisted the pt be admitted the day before for a cataract removal & stayed for 3 days post op. CABG - a very new procedure took 3 pre-op days & 10=14 post op days. We admitted pts for workups which were benign or were for lonliness (holiday admissions). We insisted the hospital formulary carry every cephalosporin that came out & they came on the market about every 3rd month.
We brought this on ourselves - yep - those of us you hold in such high esteem. We were fee for service based & if we could keep the pt one more day, do one more test - we managed a higher fee.
Its embarrassing to think what we did then. We could not monitor ourselves, so others took over. They developed protocols and processes. Good things happened - pts stayed less, procedures became more rapid, fewer complications occurred. Bad things happened too - when complications happened, pts were at home & not monitored. Formularies became strict - I no longer had the choice of medications I wanted and could give them when I wanted - I had to follow protocol. That made me mad. But, it made these procedures and treatments cheaper (yes, less reimbursement for me), but made them better too. The change became a beast that took on a life of its own.
But - is that beast any worse than the beast we had before? You might be too young to know that when there was a real admission which turned catastrophic & resulted in a huge medical bill - one spouse could lose the home to pay for the bill of the ill spouse. I sadly was part of the care of some of these patients & its nothing I'm proud of. Fortunately, that can no longer happen.
We no longer have pt dumping since its against the law, but now we take all comers & for free (well on the govt - our - dime). Was dumping better than care for free? No - neither one should be an option in this country.
I agree - medical people should be the ones who determine the medical decisions regarding patients. But - they (we) are not the best with regard to making the economic decisions. Why? We showed ourselves to be greedy b*st*rds in the 70's who were unable to control ourselves.
Even now - our colleagues who are in the outpt specialities of cardiology & IM don't have a clue how much the drugs cost their patients. Some of my colleagues don't know what the Medicare Part D "donut hole" is. I'm close enough to that it is now become a real part of my life. Our hospitalists won't even take the time to write options for discharge for drugs that are easy - like PPIs or statins. That makes therapy wait for the mess to get sorted out & it won't get sorted out by the hospitalist!
We as a group of physicians are sadly inexperienced in economics and have no patience with those who are.
You are young enough to learn to work both the medical & economic end of this healthcare system.
Perhaps, while you suffer boredom with urgent care, you can pursue an MPH and become a real agent for change rather than one of the many voices of complaint.
Yet one more degree to add to your wall. Perhaps you'll find that group of people more agreeable, but I think not......you seem to look for a fight. Just like you - I call 'em like I see 'em. Not a good sign when someone blows thru 2 careers unhappily.
Yes - I'll wait for tomorrow & the next day and the next -
Best of luck!
- Anonymous5:40 AM, July 01, 2008
Ahh I relish the Dr. Peels, Spanz's etc. What would life be without Enemies? Think how boring American History would be without the British, Indians, Civil War, Spanish, Germans, Russians, North Koreans, Vietnamese, and Arabs. Don't Curse Dr. Peel, its like the Mongoose cursing the Cobra, Grasshopper.ReplyDelete
dear anon.ReplyDelete
yours is the first explanation that makes sense to me as to the 'why's. i do know, that if i had been in practice then, i would have fought vocifersously against EMTALA as killing a fly with a sledgehammer, but i have no doubt that hospital stays were stretched to max the bill. now they are shrunk to pay for someone elses bill. i think the latter is much worse, but you may differ.
here's an appropos example from outside of medicine regarding people who don't know screwing up the people who do.ReplyDelete
- Anonymous8:06 AM, July 01, 2008
long winded anonymous: Old dude, get a screen name and join the conversation regularly! You've got moxie, grandpa... I disagree with most of what you said and I think your analysis of the post is flawed, that said, you write well and make for interesting conversation. 911's point (i think) is that the trend in medicine, due to the increasing power of administrators and gov't and the decreasing power of the MDs, ATTRACTS and PROMOTES douchebags like Dr. Peel. The man is spinning a 10 part yarn, give it time. Save the psychoanalysis for your therapist.ReplyDelete
911 wife: Psyched you are on board! I question your identity due to the reference to 911's dong. I've seen his penis, many, many times. Not pretty.
the only time you saw it angry was after i popped the rohypnol in your beer. and you wondered why your ass was bleeding the next day! you seemed to enjoy it though... told me not to stop and to put some 'oomph' behind it. sorry about the tear and resulting fistula.
- Anonymous8:40 AM, July 01, 2008
That WAS an odd camping trip...ReplyDelete
Anon, I do remember the 70's, at least the last part! It was a good time, but..A few of the things you mention ie hospital pre-admission days, longer stays, drug choices etc I disagree with. I do not recall thinking of keeping a pt longer to make more money, nor do I remember any colleagues doing that.(not that I doubt that it happened)It was the way of practice back then. Nobody dreamed of having a CABG and going home in 3-4 days!!My God man, we just split them from stem to stern! It took a few years to find out it was safe to do(for the most part)As well as many other practices in medicine..ReplyDelete
I see 911's story as, in itself, a method for ridding himself of whatever demons plague him and also give a little insight and comedy relief from our daily grind.
Just relax and enjoy the reading. Don't try to put him on the couch, it won't work and besides he ain't worth saving!!!
And 911, things in the mirror always look bigger than they really are...
I'm sorry but the man who came up with the "lookey-loo" post should simply NOT be allowed to leave ER medicine.ReplyDelete
Really, when I am having a sh*t day I meander over there and end up laughing every time.
That is pure comedy.
You sir are a jackass and a genius.
dear albinoblackbear,ReplyDelete
you just made my day. thank you.
I think of the lookey-loo post every time someone is poking their head out and staring us down at the nurse's station like I JUST didn't say where the call light was.ReplyDelete
Sit down, push your button. If you stare at ME, that means I have to interrupt what I'M doing and, perhaps, your loved one's desire to have the lights dimmed isn't quite as important.
lookey-loos multiply with increased ER wait times. there needs to be a guvment program or something and now that i think about it, i do believe i can get funding for a study (as the hard-core super complicated bench research is just rare in what we do outside of resusc.) to see if lookey loos impact time to discharge or bed. i bet they do have a positive impact on both these thing because they are so fucking annoying.ReplyDelete


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subset: commoncrawl


text:
First: "Husbands should not force their wives to submit to their lawful authority."
Second: "Wives should not force their husbands to be sexually faithful to them."
Let's try two more, slightly different:
Third: "Husbands should not demand that their wives respect them."
Fourth: "Wives should not demand that their husbands love them."
Fifth: "The Bible says that wives should subordinate themselves to and respect their husbands, but..."
Sixth: "The Bible says that husbands should love their wives as themselves, but..."
Seventh: "A husband's authority should never be exercised in an arbitrary or abusive way."
Eighth: "A wife's expectation of love should never be shrewish, excessively demanding, or insatiable."
Now, discuss.
Suggested questions:
- Is each pair of statements equally Biblical? If not, how not?
- Is each element within each pair of statements heard equally frequently? If not, why not?
- Are answers to any of the previous questions diagnostically helpful as to the spirit of the age?


text:
From Canon USACanon continues to update older professional DSLR bodies. I must say I'm pleasantly surprised they're still supporting the Mark III bodies.
The following fixes have been incorporated in the new firmware
Download the firmware
Excellent cameras still. Glad that support is still excellent. Peace of mind.
This isnt any update....just fixing some bugs!
Does this mean they f**ked up the previous update to support 200-400 1.4x? So they released a patch to fix previous firmware update?


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Renderosity Gallery of the Week - Vue
November 3, 2010 1:47 am
Tags: 3D, GOW, landscape, terrain, Vue
Whether your focus is Photography, 2D, 3D, or submitting written works to the Writers Gallery, there's no better inspiration than seeing what other fellow artists are doing. A place to see what you may have been missing, or to meet new favorite artists, the Renderosity Gallery of the Week should be your weekly destination for a quick peek at what's happening elsewhere in the galleries.
This week we take a look at the wonderful works of art created by Renderosity members posting in the Vue Gallery!
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- Renderosity Gallery of the Week for Jan 29, 2018
- Artist of the Month for September, 2017 - Sossy
- Gallery of the Week for August 28, 2017 - MojoWorld Gallery
- Gallery of the Week for August 14, 2017 - Work in Progress Gallery


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Saturday, February 28, 2009
B101's Top 10 (Bubble) Games To Watch This Weekend
Saturday's Games
Notre Dame at Connecticut
This game is obviously much bigger for Notre Dame than it is for UConn, but before we break down the Irish and their chances, we want to give a little love to (an underpaid) Jim Calhoun and his Huskies, who apparently have figured out a way to play without Jerome Dyson. The combination of A.J. Price (who Calhoun compared to Rip Hamilton and Ray Allen after his 36-point performance against Marquette on Wednesday night) and the suddenly-aggressive Stanley Robinson (how many dunks did he have the other night? 4? 5?) helped the Huskies pick up a huge road win, and helped them keep their goal of a Big East regular season title alive. A win in this game would not only make the Huskies the new No. 1 team in the country, but it would also make them the new No. 1 overall seed in our Field of 65. It might also knock the Irish out of our field after a one-week cameo. Right now, there are only three bracketolgists out there (out of the 54 listed in the Bracket Matrix) that have ND in, and we are one of them. We've had to defend their inclusion all week, and we did so by saying that a 9-9 finish and a Big East tourney win or two would be enough to get them in. What we didn't expect was that the other two Big East bubble teams - Providence and Cincinnati - would pick up ginormous wins this week. The Friars' stunning upset of Pitt almost guarantees them a 10-8 Big East record, which is something that ND likely won't have. It would also mean that the committee would have to leap-frog the Irish over the Friars for the eighth (and presumably final) Big East bid. Leap-frogging is fairly common, but it usually only happens in cases where the team being passed over has played a much softer conference schedule or has a much weaker OOC resume. That isn't the case with ND and Providence. Ultimately, the final Big East at-large is going to be decided by what the three bubble teams do in the Big East tourney, but in terms of next week's bracket, there is a chance that Providence gets in over ND.
Duke at Virginia Tech
Providence wasn't the only outside-looking-in bubble team to pick up a huge win already this week. The Hokies, who most people - including us - left for dead after they lost at home to Florida State, bounced back with a stunning win at Clemson on Wednesday to keep them very much alive in the messy ACC bubble picture. At 7-6, Virginia Tech needs to win two of its last three games to get a bid, and with the opponents they have left, two wins might be enough to get them a bid regardless of what they do in the ACC tourney. Their season-ending stretch (Duke, Carolina, at FSU) starts today with a home game against the Blue Devils, who held them to just 13 second half points in a 69-44 win back on Jan. 4. Since that game, the Hokies have been wildly inconsistent, but they have managed to compile a pretty good resume that includes road wins over Wake, Miami, and now Clemson, as well as a home win over Boston College. If Virginia Tech had done anything OOC, they'd be solidly in right now and their RPI would be a lot higher than 55. Since they didn't (their best OOC win is Fairfield), they'll have to make some noise here down the stretch. They certainly have some chances, beginning this afternoon in Blacksburg.
Temple at Dayton
This game was important anyway, but it got a whole lot more important after both of these teams lost earlier in the week. The Flyers, who have been safely in the field for what seems like forever, lost a heartbreaker at Rhode Island on Wednesday night, and as a result, they now have to adjust to life on the bubble. They have lost two straight (both were on the road, but still...), and if they were to lose at home to Temple today with a game at Xavier looming next week, a case could be made that they don't deserve an at-large bid in our next field. They might be joined on the outside looking in by Temple. We went out on a limb two weeks ago and put the Owls in our field as a bid-stealer out of the A-10, and for a couple of games, we liked how our prediction was working out. That all changed, though, on Thursday night. Temple inexplicably lost at home to lowly LaSalle (look ahead much?), and it might cost them a spot in our bracket. If the Owls can't beat the Flyers today (something URI just did), there is a good chance that the Rams replace Temple as our A-10 automatic. URI has won nine of 10 and has set itself up nicely to get the 2 seed in the A-10 tourney, which would mean avoiding top-seeded Xavier until the final.
Big XII bubble battles (Nebraska at Kansas State, Texas at Oklahoma State, Iowa State at Texas A&M)
The last few days haven't been much fun for Kansas State fans. On Tuesday, Texas A&M beat Nebraska on a ridiculous three at the buzzer to keep their at-large chances alive, and the next night, the Wildcats got destroyed at Missouri and Oklahoma State crushed Colorado. Those results made the already cloudy bubble picture in the Big XII that much harder to figure out. The biggest loser based on what's already happened this week is Kansas State. Not only were they non-competitive against the Tigers, but their RPI dropped to 76 as a result of their loss - which is more than 40 points worse than A&M's and Oklahoma State's. If the Wildcats manage to beat Nebraska today, they'll have to beat the Cowboys in Stillwater next week or they're done. Oklahoma State, meanwhile, hosts Texas tonight to begin a rough three-game stretch to end their season. They finish up with a game at Oklahoma next Saturday. If the Cowboys can win two of their next three, they'll finish 9-7, but their Big XII resume will have no real quality wins on it. They don't have much OOC either, other than wins over Siena and Rhode Island, which means even at 9-7, they might have to win two Big XII tourney games to be safe. All of this is music to the ears of Texas A&M fans, who suddenly have to like their team's chances to sneak in and grab an at-large. The Aggies have by far the best OOC resume of any of the Big XII bubble teams (they have wins over LSU and Arizona) and they have a quality win in conference over Texas. The only thing A&M will lack heading into the Big XII tourney is an above-.500 conference record. At 6-7, they need to win their next two (Iowa State and at Colorado) and then get ready to try to pull the upset over Missouri at home in their season finale. Even if they don't beat the Tigers, they'll finish at 8-8 with an RPI in the mid-to-low 30s, and with a win in the Big XII tourney, they'll probably get a bid. Two wins and they'd be a lock.
LSU at Kentucky
When we were filling out our Field of 65 last Sunday night, we had a hard time coming up with a team that deserved the final spot on the 9 line. In the end, we decided to go with Kentucky, who had just finished up an impressive season sweep on Tennessee by beating the Vols in Lexington. How did the Wildcats repay us? They got destroyed at South Carolina on Wednesday night. That loss made the already complicated SEC bubble that much more muddled, and made this game between Kentucky and LSU that much more important for the Wildcats to win. LSU, which has kind of distanced itself from the rest of the SEC teams in the field, ran their win streak to nine by beating Florida at home on Tuesday. If the Tigers win this game, they might find themselves on the 5 line next week, which would be the highest an SEC team has been in months. A win by Kentucky would work wonders for their 62 RPI and keep them in the hunt for a potential SEC East title with two games to play. South Carolina enters this weekend with a one-game lead in the division over Kentucky, Florida, and Tennessee.
Utah at BYU
The Cougars came back from a 14-point second half deficit on Wednesday at SDSU to pick up a huge road win. The win gave them the season sweep over the Aztecs and puts them in great position for a bid. A home win over first place Utah would send them from Last Four Out in last week's bracket to a very safely in on Sunday. Even if the Cougars falter here, they will be in good shape if they can win next week's games against Wyoming and Air Force to get to 11 MWC wins. The Utes won the first matchup of the season of this in-state rivalry, which ended up being the game that started their current eight-game winning streak. Utah has a shockingly high 9 RPI, which is a little deceiving since it doesn't include their opening season loss to non-D1 Southwest Baptist. They already own a win over UNLV this week, so a win here would send their 8 seed skyrocketing to at least the 6 line.
Utah State at Nevada
Many bracketologists have already written off Utah State's at large chances, but we think it is a little early for that. If the Aggies managed to win out until the conference tourney final they would end up 29-4 in the 11th-rated WAC and they currently have a 25 RPI. History is also on their side; from 2004-2007 the regular season champ lost in the conference tourney yet still got an at large bid each year. However, they would still only have one Top 50 win and 13 of their wins have come against teams with an RPI higher than 200. A win today over the second place Wolfpack would give Aggie fans plenty off confidence for the WAC tourney, which will be back in Reno in two weeks. If the Aggies were to win out and then lose the conference final they'll need to hope that it is against Nevada since it would at least be considered a road loss.
Also receiving votes: Clemson at Florida State, Ohio State at Purdue, Indiana at Penn State, Georgetown at Villanova, Pittsburgh at Seton Hall, South Carolina at Vanderbilt, UCLA at California, Arizona at Washington, Arizona State at Washington State, USC at Stanford, Cleveland State at Butler, Gonzaga at San Diego, San Diego State at TCU
Sunday's Games
Cincinnati at Syracuse & Providence at Rutgers
Both the Bearcats and the Friars picked up huge wins this week to keep their tourney hopes alive. The Friars probably had the biggest bubble win of the week in beating Pitt. The biggest problem is that it was only their second top 50 win of the season. They actually need bubble rival Cincinnati to climb up a few spots in the RPI so they could double their top 50 win total. The Friars' season sweep of the Bearcats is huge right now since there is a good chance that the two will finish tied in the Big East standings. This road game is crucial for the Friars since they have to travel to Villanova later in the week. A win would guarantee a winning record in the Big East and they likely wouldn't have to play on day one of the Big East tourney. They would likely be pitted against a fellow Big East bubble team on day two in an elimination game. The Bearcats' win over WVU this week was their best of the season (which doesn't say much). A win in the Carrier Dome would be ginormous and would get them back into the field. They'd have a great chance to get to 11 Big East wins with games against South Florida and Seton Hall remaining. They have had a relatively easy Big East schedule, since they haven't had to play any of the top teams twice, so 10-8 won't be all that great.
Michigan at Wisconsin
This one gets the stamp for B101's bubble matchup of the weekend. The Badgers can pretty much punch their dance ticket if they can pick this one up. With lowly Indiana coming in next weekend, they would be virtually guaranteed of a winning Big Ten record. The Badgers resume isn't terribly impressive, but they do have a solid RPI, and with season sweeps over Penn State and Michigan, it would be tough for them to not get a bid. We have to admit that we left the Wolverines for dead last weekend after their loss at Iowa. With the schedule they had remaining we couldn't see a .500 conference record being possible and we didn't even include them on the next four out. Then they go out and pick up yet another top 50 win over Purdue. Their resume has plenty of nice wins, but none have come on the road and they already have 11 losses. They'll get another chance later this week for a good road win up in Minnesota. The next two will also give them a chance to improve on their 2-4 record against middle-of-the-pack/bubble Big Ten teams. The Minnesota game might actually be a little more important than this one since it would give them the season sweep over a suddenly vulnerable Gopher squad.
Maryland at North Carolina State
The Terps played Duke tough for 35 minutes but still ended up with a double-digit loss. Luckily for them, Va Tech was also unable to beat the Blue Devils at home on Saturday. They now have to travel to Raleigh to take on a N.C. State team that has already beaten Wake Forest and Miami on their home court. It likely won't be an easy one for a Maryland team whose only true road win all season came against lowly Georgia Tech. Because of that fact, this game may actually be more important then their Tuesday home matchup with Wake Forest. A .500 conference record is a must and if the Terps can manage to win out and finish 9-7 all they would need is one win in the ACC tourney to be a lock.
Also receiving votes: Marquette at Louisville, Michigan State at Illinois, Missouri at Kansas, Tennessee at Florida, West Virginia at South Florida
53 comments:
- Bryan said...
Well B101 guys, we've hit that time of year again for FSU fans. My question to you is this: Should FSU collapse and lose its last 3 conference games, and then lose in its first game in the ACC tourney, (which would give them an 8-9 finishing conference record and a 5 game losing streak to end the year), would they still get in? Many on the FSU message boards feel like we are safely in no matter what happens, but having been left out over the last 3 years, including one year with a 9-7 record (but a cucpcake OOC sched.) has made me a bit cynical concerning FSU's chances. Should FSU beat Clemson on Sat, this is probably a moot point, but would like to hear your thoughts. As always, thanks for the great job you do for all of us NCAA hoops fans!
- Bracketology 101 said...
Awfully cynical Bryan...if FSU closed out on a 5 game losing streak we wouldn't like their chances. The loss in the ACC tourney would be against Virginia or N.C. State which would be a bad one. One more regular season win is all the 'Noles need to be safe.
How big is Georgetown's win today @ NOVA. I realize we have way too many losses but I still feel that 8-10 and 1 win in the BET will get us in. We have the #1 SOS, plus nobody has quality wins like us (@ UCONN, @ Nova, Memphis, Syracuse, Providence, Maryland (neutral))
Georgetown question. They're at 6-10 now with Depaul and @St John's coming up. Somewhat likely they end up at 8-10 in the Big East I think. They've won @UConn, @Nova and have beaten Memphis, destroyed Maryland, beaten Syracuse and Providence all at home. Not any terrible losses, although losing at Seton Hall and getting swept by Cincy are not great.
Do they get in by winning 3 games in the BE tourney which would mean losing in the semis? That would make them 11-11 in conference.
If fsu wins today, will they go up to a 4 or so?
- Bracketology 101 said...
It's going to be fascinating to see how Georgetown gets treated by the committee if they finish 8-10 and win one Big East tourney game. If they win two or three Big East tourney games, they'll be a lock. If they only win one Big East tourney, though, they are going to have to be leap-frogged over Providence and Cincinnati to get a bid. The Hoyas will have a much better resume than the other two in terms of quality wins and SOS, but that won't guarantee them anything. If everything plays out the way it should in the Big East, they will have finished two games behind Providence in conference and two games behind Cincinnati, who they lost to twice. If the committee favors "big wins," Georgetown might get in; if they go by conference standings, they'll be NIT-bound.
- Bracketology 101 said...
FSU could sneak on to the end of the 4 line with a win today, but they will most likely stay a 5. If they lose today (they're up 12 at the half right now), they'll probably be a 7.
FSU WINS!!!!!!!! 9-5 in the ACC, third place with only 2 games left!!!!!!!!
- Bryan said...
I've never been so happy to be wrong! Way to go FSU! If they leave us out now, there's a conspiracy afoot =)
Do bad losses even count for the selection committee? So many of these teams you seem to think are in suffered embarrassing losses. Georgetown loses to Seton Hall, ND loses to St. Johns, VT loses to GEORGIA, Kentucky loses at home to VMI (one of MANY home losses).
On the other hand, Michigan is the only bubble team with 10 or more wins vs. the RPI Top 100.
You forgot to include Michigan losing to Iowa in the bad losses....Seton Hall RPI 102 Iowa RPI 100
With pitt losing, does memphis get thier spot on the 1 line? Please tell me they dont
- Bracketology 101 said...
Pitt will still be a one seed tomorrow night. Even if Memphis wins out they will be no higher than a 2.
Bad losses are looked at and can be devastating, especially if they come late in the season.
Hey Bracketology 101....can you give us a brief rundown on how today's action affected the bubble...maybe 5 best and 5 worst days for bubble teams? Thanks
I just dont understand all the fuss about memphis... this will be a team that goes out extremly early in the tourney
- Bracketology 101 said...
Wow...what a crazy day.
The 5 best days had to belong to BYU (they'll be in the bracket on Monday), all 3 Big XII bubble teams (Oklahoma State, A&M, and Kansas State) and Dayton.
The 5 worst days belonged to Kentucky, Virginia Tech (the Hokies missed out on a great chance against Duke), Notre Dame, South Carolina, and Utah State.
Its a crazy thought, i know, but if FSU Were to win out, would they be considered for a 1 or 2?
Hey Bracketology 101 was just curious what do you think Cincinnati needs to do to get in to the dance? If they win out that would put them at 20-10 (11-7) is that enough or do they have to win a BE tourney game or 2. What if they finish 2-1 will that be enough with a BE tourney win?
It feels like the Big Ten is on a mission to get 8 teams into the dance. Michigan State and Purdue have not shown up in a couple key games, just enough to get everyone's RPI a little better, and to have some of the mediocre big ten teams pick up quality wins.
- Bracketology 101 said...
If Cincinnati wins out, and finishes 11-7 in conference, they are a lock. If they finish 10-8,they would need two Big East tourney wins to get a bid.
B101- If you were a Georgetown fan would you root against Maryland (a fellow bubble team) or for Maryland (to make the 30 pt win on a neutral court look better on the resume)? Thanks for the input.
Will Florida be on the outside looking in in your bracket tomorrow?
- Bracketology 101 said...
We are going to look long and hard at the SEC tonight, and there is a very good chance it is a 4-bid league in our next bracket. Florida or Kentucky will be on the outside looking in.
It's a tough call, but we would probably root AGAINST Maryland if we were Georgetown fans. The Hoyas have a lot of other quality wins to fall back on, and they are going to need a lot of other bubble teams to lose games if they are going to make it. Plus, if Georgetown is going to make the field, it will be because of what they do from here on out (two wins to get to 8-10 and then two Big East tourney wins). It won't be because they beat the Terps.
If "Conferences don't get bids, teams do" why would either Florida or Kentucky be in the field? Neither team deserves to be in, but it's almost like you're saying the SEC has to get at least 4 bids so we've gotta put either Kentucky or Florida in there. That makes no sense at all.
Does the SEC Commissioner being the chairman have anything to do with this decision, or do you really feel Florida/Kentucky are deserving of a bid?
- Bracketology 101 said...
We hate to be cynical, but we don't believe in the committee's mantra that "conferences don't get bids, teams do." Conference affiliation is inherently involved in any team's inclusion/exclusion from the bracket, and it's especally important for bubble teams. The conference you are in affects who the bulk of your schedule is played against, and who most of your qualty wins come against, and while the committee will never admit it, we find it hard to beleve that they don't know or don't consider the fact that they are sometimes putting the seventh or eighth best team from one league in over the third, fourth, or fifth best from another league. It has to go through their mind, and it goes through ours too when we put together our bracket each week.
Being the fifth best team in a medicore league like the SEC is not a good thing to have on your resume if you want to get a bid. That's where Kentucky sits right now, and considering they did little OOC, there is a good chance they'll be on the outside looking in tomorrow when our latest bracket gets released.
- Keith Bell said...
What effect does BYU's win over Utah this week have on the picture with the MWC and for BYU's chances for an at-large? Also, the top five teams (Utah, BYU, UNM, SDSU and UNLV) in the MWC figure to each pick up 20 wins, which is quite an accomplishment for the conference. The MWC is not gonna get five bids though (I would expect two or three.) Which of these teams do you project as making the tournament?
- Bracketology 101 said...
We're still crunching the numbers for tomorrow's bracket, but right now, Utah is a lock out of the MWC and BYU, after their huge week, looks solid for a bid too. UNLV is right on the bubble and will be one of last teams in or last teams out, while San Diego State and New Mexico will stay on the outside looking in.
Fair enough, but just because Kentucky doesn't deserve to be in, doesn't mean Florida does.
Yes Florida has 21 wins but they also have an SOS of 88, a non-conference SOS of 228, and 15 of their 21 wins against teams ranked 100th or lower in the RPI.
They're 2-6 against the top 50.
Their only win of note is a neutral site win vs. Washington, but that's offset by one of the worst losses on any bubble team's resume (#204) UGA.
They're 2-6 on the road with their best win being against #78 Auburn. They only played 1 true road game in the non-conference (L to FSU)
They're likely to finish 9-7 in the 6th best conference.
I'm still trying to figure out a positive to their resume. There's no way they'd finish in the top 9 of the ACC.
- Bracketology 101 said...
We agree that neither team looks very good on paper right now, but we have to look ahead a little bit when we do our bracket. The fact that Florida hosts Kentucky this weekend helps the Gators' chances to stay in the field (barely).
"We agree that neither team looks very good on paper right now, but we have to look ahead a little bit when we do our bracket. The fact that Florida hosts Kentucky this weekend helps the Gators' chances to stay in the field (barely)."
If they dont look good when you look at achievments... Where do they look good? Because the o-dome, today was not one of those places
how about penn state after losing to ohio st. and winning against indiana??
How does UC look as far as the upcoming bracket looks? And when will you release the bracket tomorrow?
U realize that there are... like... 8 UC's? Cincy, Cal, Conneticut, Clemson...
You are right my fault, Cincinnati. I'm just so used to it. Apologies.
Cincy did not only lose today but looked absolutely horrific. Note the committee has said it will take into account how you win and how you lose.
- Lee said...
You state that MD would be a lock with a 9-7 conference record and an ACC tourney win, isn't that a bit of stating the obvious? The way I see it they should be in with 9-7 and a 1st round loss or 8-8 and a first round win. Maybe lock wouldn't be the right word for this but something like 90-95%...
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A plain, one-bedroom apartment in Williston, N.D., rents for $2,100 a month. For this price, you could rent a one-bedroom apartment in New York City.
Williston is not New York City. There are 30,000 residents and one department store. The nearest city is two hours away.
Rents are so high in Williston because the town is in the middle of an oil boom. Unemployment is below 1 percent, and workers are flooding into town.
But the workers, by and large, don't want to stay in Williston. The town is full of men who live hundreds of miles away and who have no intention of moving their families to town.
For Williston to become a place more people want to call home, it's going to need more stuff. More stores. More restaurants. But with high-paying oil jobs easy to come by, it's hard for stores and restaurants to hire employees.
So Williston is in this weird situation. People are reluctant to move here until there are more places like stores and restaurants. But it's hard for those stores to open until there are more people here.
It's a chicken-and-egg problem.
The town's solution is to build a gigantic chicken. Or maybe it's an egg. Actually, its a huge rec center with a golf simulator, batting cages, tennis courts, swimming pools and a lazy river.
That's Williston's solution. Build and build and build. If everything works out, there could be 40,000 oil wells in the area. People will have to stick around to maintain them. Local officials hope those people will settle down and turn Williston into more than a boomtown.
The small town of Williston, North Dakota is booming. Oil workers have flooded the town and are busy drilling the surrounding countryside. But all this growth creates an economic problem and leads to a question: How do you turn a boom town, into a real town.
Here's David Kestenbaum with NPR's Planet Money team.
DAVID KESTENBAUM, BYLINE: To understand, how dramatically things have changed in Williston, meet Rich Vestal. Rich runs a supply company. You want salt, cement? He's your guy. But there was a time here when no one wanted anything.
RICH VESTAL: We didn't have an order for 32 days, straight. Yeah, it was pretty grim.
KESTENBAUM: Now, thanks to new drilling techniques, including fracking, things are very different. Rich has hired workers who come from all over the country. They needed a place to stay, so he bought a house.
VESTAL: Was down by our own warehouse, we paid about $10,000 for it.
KESTENBAUM: Then, bought another one.
VESTAL: Well we bought the house next door from the lady that lived next door. She passed away so we...
KESTENBAUM: Also, one by the cemetery.
VESTAL: And then we wound up - we bought 14 trailer houses up in a trailer park.
KESTENBAUM: There's more.
VESTAL: We bought some condos.
KESTENBAUM: Grand total?
VESTAL: We got 68 now?
KESTENBAUM: You have 68 houses.
VESTAL: Yup.
KESTENBAUM: In a boom town, there is never enough housing. Williston has gone from population 13,000 to 30,000.
GERARD FEIST: This is a one bedroom, 860 square feet...
KESTENBAUM: This apartment Gerard Feist is showing off, it was just built. It's very basic. You could be anywhere in America. Except for the one thing, the price.
FEIST: The rent on this one bedroom, $2100, I believe, per month.
KESTENBAUM: This is basically New York, Manhattan rate.
FEIST: It is, exactly.
KESTENBAUM: Could we negotiate the rent with you?
FEIST: No, it's non-negotiable.
KESTENBAUM: Outside, it is not Manhattan. There is one department store. And the next town of any size is a two hour drive.
So the question is: Will the workers who've come to town, move here, make this place their real home? Workers like this guy.
JIM WENTLAND: My name is Jim and I drive truck.
KESTENBAUM: Can I just say that's an awesome mustache?
WENTLAND: Oh, thank you. Been growing it for about 20 years now.
KESTENBAUM: Jim Wentland has a huge walrus mustache and a perfectly nice home, it's just 1,000 miles away in Washington State. He works here three weeks at a time, crazy long hours - then rushes home.
Would you think about moving here?
WENTLAND: No. Not going to bring my family up here. Not right now.
KESTENBAUM: What would need to change here?
WENTLAND: Something to do. Family activity-wise, what is there? Couple of movie houses and a bowling alley?
KESTENBAUM: What is there at home?
WENTLAND: Skate parks, they have soccer fields and city parks
KESTENBAUM: At this point, a woman standing nearby, Theresa Labor, chimes in. Williston has that, she says.
THERESA LABOR: We got a city park with a skate park in it right downtown. I don't live here either. But...
WENTLAND: You used to and you left.
LABOR: Right. And I don't...
KESTENBAUM: Got that on tape?
For Williston to become a place more people want to call home, it's going to need more stuff - more stores, more restaurants. But here, too, there's a problem - finding people to work in those places.
Shawn Wenko with the city's economic development office.
SHAWN WENKO: We have seven-tenths of one percent unemployment rate here.
KESTENBAUM: Wait, what's the unemployment rate?
WENKO: Seven-tenths of one percent.
KESTENBAUM: So that means less than 1-in-100 people are unemployed.
WENKO: Right, correct. If you're not working in western North Dakota, or Williston or Williams County, you're unemployable.
KESTENBAUM: There's a serious labor shortage in town. Even McDonalds, had trouble opening. So Williston is in this weird situation. People are reluctant to move here until there are more places like McDonalds. But it's hard for those stores to open until there are more people here. It's a chicken and egg problem. And the town's solution is to build a gigantic chicken. Or maybe it's an egg.
Actually it's a huge rec center. Again, Shawn Wenko.
WENKO: Workout facilities, you know, golf simulator batting cages. Tennis courts, racquetball courts. Basketball courts, a turf field to a running track. It's got three swimming pools in there.
KESTENBAUM: Three swimming pools?
WENKO: It's got three. It's got Olympic-size swimming pool, a dive pool and a lazy river.
KESTENBAUM: What's that?
WENKO: A kind of an inner tubing style of river.
KESTENBAUM: Indoors here in North Dakota?
WENKO: Indoor is correct.
KESTENBAUM: That's Williston's solution: Build and build and build. If everything works out, there could be 40,000 oil wells in the area. And someone will have to stick around to maintain them.
David Kestenbaum, NPR News. Transcript provided by NPR, Copyright NPR.


text:
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