Without evidence of benefit, an intervention should not be presumed to be beneficial or safe.

- Rogue Medic

Happy Play God Day

January 9th is Play God Day.

OK. I’ll play. What could possibly go wrong.

I will start before The Beginning. I am everything and I am perfect.

Do I ruin that by creating something other than me? Am I lonely, bored, needy, neurotic, . . . ? What fallibility would inspire me to create creatures to slaughter? According to my biography, this is where I start to screw things up, but it could have been earlier.

Do I ruin perfection by creating something imperfect? Apparently. According to my biography, I do not accept that my far-from-perfect actions are demonstrations of my lack of perfection, but I make the rules, so I will torture you forever for pointing out my failures. It seems fair to me.

Remember that my name is Jealous and It isn’t bad when I do it. I said so. And it seems that I have to say so, because I can’t write. Why can’t I write? Why am I the worst communicator of all time? Remember, I will torture you forever for pointing out my failures.

Why would I choose to create evil and abolish my perfection? I didn’t create evil. Evil created itself and I use the existence of evil so that I can claim that I am better than something else. Don’t expect me to be reasonable. Remember, I will torture you forever for pointing out my failures. If I can create myself out of nothing, why can’t evil? And if I am not as good as I claim to be, maybe evil is not as bad as I claim that it is.

Was I ever perfect, if I can create evil, or let evil be created, or let evil create itself? So what if I get cranky and drown everyone on the planet, except for eight supposedly good people, who weren’t as good as I thought? Was everyone else really evil? What about their innocent fetuses? If I really wanted to get rid of all of the bad people, maybe I should have chosen passengers a little better. Maybe I could have just dealt with them individually. Look at me being surprised by something I didn’t anticipate, again.

Why did I use such an inaccurate weapon? Why not use a laser? That would impress people. A technology that the creators of the Gods did not know about! That would have been much more impressive than a bigger than usual flood. Maybe I should have created better writers.

Why would I want to be such an abysmal failure as the Jewish/Christian/Muslim God? Maybe I just don’t think for myself. Maybe I was just created by people who were not aware of their prejudices and logical fallacies. Richard Feynman has comment on the reports of flying saucers, which I like to modify to apply just as accurately to the Gods.

It is not unscientific to make a guess, although many people who are not in science think it is. Some years ago I had a conversation with a layman about flying saucers God — because I am scientific I know all about flying saucers God! I said “I don’t think there are flying saucers Gods”. So my antagonist said, “Is it impossible that there are flying saucers Gods? Can you prove that it’s impossible?” “No”, I said, “I can’t prove it’s impossible. It’s just very unlikely”. At that he said, “You are very unscientific. If you can’t prove it impossible then how can you say that it’s unlikely?” But that is the way that is scientific. It is scientific only to say what is more likely and what less likely, and not to be proving all the time the possible and impossible. To define what I mean, I might have said to him, “Listen, I mean that from my knowledge of the world that I see around me, I think that it is much more likely that the reports of flying saucers God are the results of the known irrational characteristics of terrestrial intelligence than of the unknown rational efforts of extra-terrestrial supernatural intelligence.” It is just more likely. That is all.

The Character of Physical Law (1965)
chapter 7, “Seeking New Laws,” p. 165-166: video


I could have arranged for good people to be rewarded and bad people to fail. I used to have you believing that I did that and you humans abused people who were different, because that was a sign from me that those people are evil. Many of you haven’t stopped. I love irrational people. Billions of irrational people can’t be wrong, so keep killing each other over the right interpretation of my biography.

If I were going to be a God for a day, I might increase the ability of people to understand. A God capable of communicating in a way that people could agree on would suggest that the God is not made by people, but the only thing that Christians seem to agree on is that they like Jesus. A real God could have communicated a real message, but what should we expect from the guy who wrecked the Tower of Babel, which we have long since surpassed. Ooops.


Happy Bill of Rights Day – 225 Years Old


The Bill of Rights was ratified on December 15, 1791, which makes today the 225th anniversary of being signed into law. The Bill of Rights protects the interests of minorities from oppression by tyrannical majorities. This is why we are not really a democracy, but a constitutional republic.

If a majority decides that a minority should not be entitled to the same rights as the majority, or promotes some rationalization of the difference as not being a valid difference, that minority can appeal to the courts for relief. On the other hand, there are no absolute rights, which would invalidate all other rights.

You can be executed for a crime you did not commit, even if you can prove that you are innocent. You have to appeal to the governor or president for intervention. As the Supreme Court decided –

Held: Herrera’s claim of actual innocence does not entitle him to federal habeas relief. Pp. 6-28.[1]


Due process of law does not require that the innocent be set free. Life, Liberty and the pursuit of Happiness are not to be found in the American Constitution. Life, Liberty and the pursuit of Happiness are not to be found in the Bill of Rights.

Rights also come with responsibilities. We need to respect the rights of others, no matter how much we might think that others cannot be trusted to make those decisions, while we claim to be able to make these same decisions, not just for ourselves, but for others.

If people of different races want to marry, the state governments are not permitted to use their authority to sanction marriages to deprive citizens of their right to marry based on tradition. States rights have limitations, just as individual rights have limitations.

Discriminating against citizens of a politically incorrect group for decades, or even centuries, is not a justification for continuing to deprive them of equal treatment under the law.

Others may use their freedom, which always comes with responsibilities, in ways we do not like, but that is part of the price of freedom.

Even though slavery was legal at the time of ratification of the American Constitution and Bill of Rights, and is still endorsed by the Bible, we have recognized that slavery is bad. Our Constitution caught up with a lot of the rest of the world.

The Bible still endorses slavery and says that I can sell my daughter as a sex slave.

What progress we are making. In the Middle Ages they would have burned me. Now they are content with burning my books. – Sigmund Freud

The Bill of Rights is much better than the Bible. Go blaspheme in celebration of the Bill of Rights, which protects us from those who would burn us, or our writing, or otherwise punish us for being honest.


[1] Herrera v. Collins (91-7328), 506 U.S. 390 (1993)
Argued October 7, 1992
Decided January 25, 1993
US Supreme Court


In criminal cases, thetrial is the paramount event for determining the defendant’s guilt or innocence. Where, as here, a defendant has been afforded a fair trial and convicted of the offense for which he was charged, the constitutional presumption of innocence disappears. Federal habeas courts do not sit to correct errors of fact, but to ensure that individuals are not imprisoned in violation of the Constitution. See, e.g., Moore v. Dempsey, 261 U.S. 86, 87-88. Thus, claims of actual innocence based on newly discovered evidence have never been held to state a ground for federal habeas relief absent an independent constitutional violation occurring in the course of the underlying state criminal proceedings.



Flag burning, patriotism, and reality


Tweet by President-elect Donald Trump on flag burning

Is appearance more important than reality?

Why do people burn the American flag?

There may be many reasons, but the essence appears to be an attempt to shock people to recognize what the flag burners see as hypocrisy.

What is the purpose of prohibiting burning of the American flag?

Some people place more value in this symbol of America (the flag), than they do in what makes America great (the Constitutional protections of the rights of Americans).

Is President-elect Trump an opponent of the American Constitution? Is President-elect Trump just engaging in a politically correct theatrical display for people who do not seem to understand that the American Constitution doesn’t care if their feelings get hurt?


In 1798, Congress passed, and President John Adams signed, the Alien and Sedition Acts.[1] These restricted eligibility to vote, restricted immigration, allowed for increased deportation of aliens considered dangerous, and made criticism of the federal government illegal. This is one example of Founding Fathers acting in a way that is contrary to what many consider their original intent.

Recently deceased Supreme Court Justice Antonin Scalia voted in the majority to protect flag burning in 1989.[2] Did Justice Scalia hate America, hate the American flag, or is it more complex than an early morning tweet can express?

In 1943, during World War II, the Supreme Court decided on a variation of this concept. Is it Constitutional to force people to demonstrate patriotism?

To believe that patriotism will not flourish if patriotic ceremonies are voluntary and spontaneous instead of a compulsory routine is to make an unflattering estimate of the appeal of our institutions to free minds.[3]


Real patriotism is not a politically correct compulsory display.

But freedom to differ is not limited to things that do not matter much. That would be a mere shadow of freedom. The test of its substance is the right to differ as to things that touch the heart of the existing order.[3]


The American Constitution does not authorize thought crimes.

If there is any fixed star in our constitutional constellation, it is that no official, high or petty, can prescribe what shall be orthodox in politics, nationalism, religion, or other matters of opinion or force citizens to confess by word or act their faith therein. If there are any circumstances which permit an exception, they do not now occur to us.[3]


What about those who claim that Americans have risked their lives, and even died, to protect the sanctity of the American flag? Does service in any branch of the American military contain any oath to protect the American flag?

(a) Enlistment Oath .-Each person enlisting in an armed force shall take the following oath:
“I, ____________________, do solemnly swear (or affirm) that I will support and defend the Constitution of the United States against all enemies, foreign and domestic; that I will bear true faith and allegiance to the same; and that I will obey the orders of the President of the United States and the orders of the officers appointed over me, according to regulations and the Uniform Code of Military Justice. So help me God.”


The So help me God is optional, since there is no truth to the myth that there are no atheists in foxholes and the American Constitution prohibits all religious requirements for service.

The oath is to protect the American Constitution, which protects flag burning. The oath is not to protect the American flag.

Even Jesus stated opposition to this kind of political theater.

5 “When you pray, you are not to be like the hypocrites; for they love to stand and pray in the synagogues and on the street corners [a]so that they may be seen by men. Truly I say to you, they have their reward in full. 6 But you, when you pray, go into your inner room, close your door and pray to your Father who is in secret, and your Father who sees what is done in secret will reward you.[5]


What does it say about America that we reward theatrical patriotism, rather than respect for the Constitution which makes America great?

Or is President-elect Trump taking initial steps to try to get Citizens United v. Federal Election Commission[6] overturned by expressing that not everything is protected expression? Who can tell with someone who expresses himself in such a vague manner?

Is appearance more important than reality?


[1] Alien and Sedition Acts
Primary Documents in American History
Library of Congress page

[2] Texas v. Johnson, (1989)
No. 88-155
Argued: March 21, 1989
Decided: June 21, 1989
United States Supreme Court

[3] West Virginia State Board of Education v. Barnette (No. 591)
Argued: March 11, 1943
Decided: June 14, 1943

[4] §502. Enlistment oath: who may administer
Text contains those laws in effect on November 28, 2016
US Code page

Amended in 1962 – inserted “So help me God” in the oath, and “or affirmation” in text.

[5] Matthew 6:5-6
New American Standard Bible (NASB)
You can go to the site and look up all of the other versions of the Bible or just pick up a Bible and read this.
Bible Gateway

[6] Citizens United v. Federal Election Commission


Deadpool – maybe it only hurts when you laugh, but you laugh anyway


What if you took an extremely sarcastic person and made him a god? You could have a triple R rated success.

Horace Walpole has a great quote, that seems to baffle the sanctimonious –

The world is a comedy to those that think; a tragedy to those that feel.

Jonathan Swift and Lewis Carroll might regret that this movie only skims the surface in its satire, but they had to use satire to avoid prosecution for blasphemy, heresy, and other thought crimes that are trying for a comeback.

Marvel vs. DC. iPhone vs. Android. Fire vs. private vs. hospital. Little-Endian vs. Big-Endian and High Heels vs. Low Heels.[1] Mine is the One True WhateverTM.

Deadpool kneel before Zod sign 1a
Best still of Deadpool at Comic Con



Election season is the perfect time for Deadpool to be in theaters, because the preachers, pundits, and politicians are more absurd and obscene than anything in the movie.

Satire is a sort of glass wherein beholders do generally discover everybody’s face but their own; which is the chief reason for that kind reception it meets with in the world, and that so very few are offended with it.[2]


Deadpool doesn’t even try to fit the right wing or left wing politically correct model. The preachers, pundits, and politicians claim that the greater obscenities they promote are virtues. Perhaps they are so ridiculous, they no longer need others to ridicule them.


Alice laughed. “There’s no use trying,” she said: “one can’t believe impossible things.”

“I daresay you haven’t had much practice,” said the Queen. “When I was your age, I always did it for half-an-hour a day. Why, sometimes I’ve believed as many as six impossible things before breakfast.”[3]


We should soon see an honest emulation among the married women, which of them could bring the fattest child to the market. Men would become as fond of their wives, during the time of their pregnancy, as they are now of their mares in foal, their cows in calf, or sow when they are ready to farrow; nor offer to beat or kick them (as is too frequent a practice) for fear of a miscarriage.[4]


If you work in a medical field, you should have seen enough misery to have an appreciation of a dark sense of humor and an understanding of the fraud of treating others as less deserving because they are in some way different.

A world of collateral damage is a comedy. Some of us keep going for the even bigger laugh of the bigger body count.

A world of starvation is a comedy. Some of us oppose using GMOs (Genetically Modified Organisms) to prevent the even bigger laugh of the bigger body count.

A world of death by preventable illness is a comedy. Some of us oppose using vaccines to prevent the even bigger laugh of the bigger body count.

The truly twisted sense of humor is not the obscenity in this movie, but the sanctimony of those encouraging killing, in the name of whatever, while claiming to be good.


[1] Part I, Chapter IV
Mildendo, the metropolis of Lilliput, described, together with the emperor’s palace. A conversation between the author and a principal secretary, concerning the affairs of that empire. The author’s offers to serve the emperor in his wars.
Gulliver’s Travels into Several Remote Nations of the World (1726)
Jonathan Swift
The University of Adelaide Library
University of Adelaide
South Australia 5005
Chapter IV

For,” said he, “as flourishing a condition as we may appear to be in to foreigners, we labour under two mighty evils: a violent faction at home, and the danger of an invasion, by a most potent enemy, from abroad.


[2] The Preface of the Author
A Full and True Account of the Battle Fought Last Friday Between the Ancient and the Modern Books in Saint James’s Library. (1704)
Jonathan Swift
The Literature Network

[3] Chapter 5: Wool and Water
Through the Looking-Glass, and What Alice Found There (1871)
Lewis Carroll (Charles Lutwidge Dodgson)
The University of Adelaide Library
University of Adelaide
South Australia 5005
Chapter 5

[4] A Modest Proposal for preventing the children of poor people in Ireland, from being a burden on their parents or country, and for making them beneficial to the publick (1729)
Jonathan Swift
The University of Adelaide Library
University of Adelaide
South Australia 5005
Full Text


Why We Need Blasphemy Laws

The people promoting blasphemy laws are telling us that they believe their gods are impotent in the face of criticism.

The gods don’t enforce blasphemy laws, so people have to correct that mistake of the gods.

“We have killed Charlie Hebdo. We have avenged the Prophet Mohammad.” – The claims of one of the murderers of blasphemous journalists. These claims were made while the murderers were bravely running away because their gods cannot protect them.[6]

Does anything mock the gods more than having to get people to kill in the name of the gods?

You can kill people, but you cannot kill ideas.

Charlie Hebdo cover following an attack by criticism of blasphemy – translation – “The Koran is shit at stopping bullets.”

Maybe the message is that the gods no longer care about criticism. Religion changes. We have tens of thousands of variations of Christianity just in America – and we aren’t even the home of Christianity. Many of America’s first settlers were fleeing persecution by Christians for slightly different interpretations of the One True GodTM.


Should Christians emphasize the part of the Bible where Jesus tells us –

34“Do not suppose that I have come to bring peace to the earth. I did not come to bring peace, but a sword. 35For I have come to turn

“‘a man against his father,
a daughter against her mother,
a daughter-in-law against her mother-in-law—
36 a man’s enemies will be the members of his own household.’[a]
37“Anyone who loves their father or mother more than me is not worthy of me; anyone who loves their son or daughter more than me is not worthy of me.
Matthew 10:34-37


Or should we ignore these parts and be more moral than the Bible commands in this and its other bad parts?

Is that sentence an example of blasphemy?

That depends on the reader. When quoting the Bible is blasphemous, is it a problem with the Bible, with the quote, with the intent, with the offense taken by the reader, or with something else?


Which Christians determine what is blasphemy to Christians?

Which Jews determine what is blasphemy to Jews?

Which Muslims determine what is blasphemy to Muslims?

Which Buddhists determine what is blasphemy to Buddhists?

Which Scientologists determine what is blasphemy to Scientologists?

Which Wiccans determine what is blasphemy to Wiccans?

Which Satanists determine what is blasphemy to Satanists?

If the Satanists blasphemy judges conflict with the branch of Christians established as the blasphemy judges for Christianity, can anyone break the tie without violating First Amendment?[2] Which part wins when there is conflict within an amendment?

Which is more important – protecting religion from the same criticism every other adult organization has to face or protecting the expression of ideas? If the ideas are unimportant, there is no need for laws or violence. If the ideas are important, suppression only protects the thoughtless and the willfully ignorant.


Our beliefs need to be protected against criticism, because we might start to think for ourselves.

If we can’t critically examine the tens of thousands of different, and amusingly contradictory, interpretations of the absolute truths of Christianity, how are we supposed to identify the one true version of the absolute truth? Religion is a multiple choice test question in which we are told that there is one best answer, but that those giving the test are not required to explain their answer in order to protect the validity of the testing process.[3]

It probably is the religion our parents raised us to believe, because we were given those parents for a reason.

When faith is weak, it must be protected with laws and violence. When faith is real, it doesn’t need to be petty and vindictive and immoral.

Federalist 10[4], Federalist 51[5]

Blasphemy is a crime in search of victims. Try to claim – I was blasphemed!  If you are not a god, your claim would be a blasphemy.

Blasphemy is a thought crime intended to discourage thinking.

Thinking is bad – Blasphemy laws are good.

Someone considers your freedom of religion to be a blasphemy against their religion. We need to help them impose their blasphemy laws on you. Then we can pretend that blasphemy laws will stop violent people from killing, just as gun laws stop violent people from killing.

12 people were murdered by a bunch of people who ran away, because they knew their gods would not protect them for supposedly defending their gods.

Undaunted by the gunning down of its leading cartoonists, the French weekly Charlie Hebdo plans to print a million copies next Wednesday, almost 30 times more than usual.

French media rallied around the satirical paper on Thursday, a day after militants killed 12 people as journalists held an editorial meeting, to ensure its next edition appears on time by offering funds and office space.[6]


We must impose blasphemy laws to protect ignorance. Ignorance appears to be sacred to the gods.

We must attack blasphemy to increase the circulation of blasphemous ideas.

The legitimate powers of government extend to such acts only as are injurious to others. But it does me no injury for my neighbour to say there are twenty gods, or no god. It neither picks my pocket nor breaks my leg. . . .

Reason and free enquiry are the only effectual agents against error. Give a loose to them, they will support the true religion, by bringing every false one to their tribunal, to the test of their investigation. They are the natural enemies of error, and of error only. Had not the Roman government permitted free enquiry, Christianity could never have been introduced. Had not free enquiry been indulged, at the aera of the reformation, the corruptions of Christianity could not have been purged away. If it be restrained now, the present corruptions will be protected, and new ones encouraged. . . .

Millions of innocent men, women, and children, since the introduction of Christianity, have been burnt, tortured, fined, imprisoned; yet we have not advanced one inch towards uniformity. What has been the effect of coercion? To make one half the world fools, and the other half hypocrites. – Thomas Jefferson.[7]



[1] Matthew 10:34-37
The Bible
New International Version (NIV)
Verses on BibleGateway.com

[2] First Amendment
US Constitution

Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof; or abridging the freedom of speech, or of the press; or the right of the people peaceably to assemble, and to petition the Government for a redress of grievances.


[3] Cognitive Examinations
National Registry of Emergency Medical Technicians
About NREMT Examinations

Consensus by the committee must be gained so that each question is in direct reference to the tasks in the practice analysis, that the correct answer is the one and only correct answer that each distracter option has some plausibility, and the answer can be found within commonly available EMT textbooks.


[4] The Federalist No. 10
The Utility of the Union as a Safeguard Against Domestic Faction and Insurrection (continued)
Daily Advertiser
Thursday, November 22, 1787
[James Madison]
Full Text

[5] The Federalist No. 51
The Structure of the Government Must Furnish the Proper Checks and Balances Between the Different Departments
Independent Journal
Wednesday, February 6, 1788
[James Madison]
Full Text

[6] Attacked satirical French weekly to print a million copies next week
by Tom Heneghan
Paris Thu Jan 8, 2015 1:02pm EST

[7] Notes on the State of Virginia.
by Thomas Jefferson.
Edited by William Peden.
Chapel Hill: University of North Carolina Press for the Institute of Early American History and Culture, Williamsburg, Virginia, 1954.
© 1987 by The University of Chicago
Free Full Text at The University of Chicago


Belly flops with cliches, proves he’s a Satirist (You have a dirty mind if you’re thinking what I think you’re thinking this means)


What happens when EMS becomes so distorted that it is embarrassing?

Things get silly.

Image credit.

By silly, I mean the satire starts off simply, but then becomes a multi-layered satire that deserves its own Wikipedia page. There is no page, yet, or is there?

Kelly Grayson started us off with an article about EMS cliches.

From the blank stares I got from all assembled, I realized that none of them had ever seen Bull Durham. So while I educated them in the Tao of Crash Davis, I started thinking about the clichés we spout in EMS. Every cliché has at its root a central truth; that’s how they get to be clichés in the first place.

But nothing is so good as a well-placed cliché as a substitute for real wisdom and knowledge. Just insert one of these babies into a social media comment thread and watch the “Likes” pile up!

. . .

If you learn to use these simple EMS clichés, I guarantee that you will develop a reputation as a paramedic sage in no time. Especially to people who don’t know better.[1]


You’re going to have to read the full article yourself. Polonius would have been skewered several acts earlier if Kelly had been there, but this gets better.

Then Happy Medic turns up the satire by responding to Kelly.


8. “We cheat death.” We do, daily! I have a T-shirt with the Grim Reaper being slapped in the face by a bad ass medic with sunglasses and everything. You are so narrow minded you can’t see how we bring the dead back everyday. Epi works Kelly![2]


Go read the rest, too.

Ridicule is the only weapon which can be used against unintelligible propositions. Ideas must be distinct before reason can act upon them; – Thomas Jefferson.

Finally, Tor eckman takes it to Eleventy!!11!!! in the comments.

I also teach them to think and look for clues on scene, like just last week I got to see the lights come on in this “newb” Paramedic when he wasn’t going to spinal a patient in a MVC until I had him walk down the bank and look at the car, after seeing the mechanism he came back up, told the patient that he was lucky he wasnt paralyzed for walking up the bank. We did a standing take-down right then and there. By the time we got to the hospital the pt had pretty bad back pain, can you imagine if we hadn’t put him on the backboard? lawsuit. So go ahead and make fun of the noobs, I’ll take them and teach them.[3]


I think that someone should Call the Cops for all of this abuse of the witless, because the giggles just keep on coming.

Maybe this is an example of Poe’s law (a legitimate comment from some person who is so blind to their bias that they do not notice the self-parody)?[4],[5]

Maybe, but Tor eckman[6] is a character from Seinfeld. Tor eckman is a ridiculous alternative medicine practitioner, much like our ridiculous EMS providers who do not understand what it means for a treatment to improve outcomes.

Go spend some time reading the comments on social sites and you will see that this might not be satire, but somebody should take credit for it if it is satire – and somebody should be ridiculed for it if it is not satire.


[1] The stupid EMS cliche usage guide – Using phrases like ‘We cheat death’ is so much easier than actually thinking
September 30, 2013
The Ambulance Driver’s Perspective
by Kelly Grayson

[2] Kelly Grayson belly flops with cliches, proves he’s a Noob
Happy Medic
October 3, 2013

[3] Tor eckman’s comment
Kelly Grayson belly flops with cliches, proves he’s a Noob
Happy Medic
October 3, 2013

[4] Poe’s law

Without a blatant display of humor, it is impossible to create a parody of extremism or fundamentalism that someone won’t mistake for the real thing.


[5] Poe’s law

The site’s description of Poe’s law appears to qualify as a parody of extremism or fundamentalism that someone won’t mistake for the real thing. Or is it the real thing that someone will mistake for parody?

Will Andrew Schlafly wait until his mother is dead before he admits that he was just trying to please his mother, just not as violently as Norman Bates? Or is he the real thing that someone will mistake for parody?

[6] The Heart Attack


Blogging and Anonymity

CCC – Captain Chair Confessions writes anonymously.[1] Is that bad?

Are we so incapable of assessing the content of the blog, that it only becomes relevant when we can attach a normal looking name to the blog, no matter how fictitious that name might be?

I don’t put my name on my blog.

Does that change the validity of the research I write about?

What about when I criticize someone? Is that criticism less valid than if I put a name on my blog?

I criticize some big companies. None of them have contacted me about any kind of libel suit, or any kind of slander suit for any of the podcasts I have been on.

My email is right there in the upper right of the blog. I have always has been.

People think that attaching a name to something gives it accountability.

Oprah Winfrey has made a career of giving a stage to frauds – Deepak Choprah, Jenny McCarthy – even Dr. Oz is promoting nonsense. There are plenty of others.

We know their names, but they are frauds.

Where is the accountability for all of the fraud that has come from her show?


Deepak Chopra is one of the highest paid entertainers in the US.

There is a lot of discussion of Mitt Romney and Barack Obama. They use their names. Does anyone think that both of them are trustworthy?

What about Michael Moore and Rush Limbaugh? They are both famous liars, who will distort anything to make a political point. Having their names on their lies doesn’t seem to encourage them to behave ethically.

Requiring a name on a blog is like requiring a medic to make the magic phone call to a medical command doctor. It has the appearance of making things better, but none of the substance.

This is a salve for the people who are not capable of determining what is real – people who think that a good argument for something is, What if somebody sues?

Does the blog identify an employer?

Does the blog portray that employer in a negative light?

Is the blog encouraging people to abuse patients?

There are many similar questions that may be asked.

There are a variety of ways of answering some of these questions.

The most important question is does this blog get me to think about what I do, so that I want to be better at patient care?


The problem is not anonymous blogging.

The problem is people who want to discourage views, but don’t have any valid criticism of those views.

Medicine and EMS are very traditional. We need to destroy those traditions and start doing what is best for the patients.

Organizations that harm patients in order to do what they think protects them from liability need to be criticized.

During the creation of the United States of America, there were plenty of discussions about the way the government should be set up. The Federalist Papers were written under the pseudonym Publius.[2] We still do not know who wrote some of the essays. The contrary position was taken in the Anti-Federalist Papers, written under the pseudonyms Cato, Brutus, Centinel, and Federal Farmer.[3]

If an anonymous blog is not good enough for you, buy some tissues and go whine somewhere else.

I am proud of my fellow anonymous and semi-anonymous, bloggers.

I am embarrassed by people incapable of substantive criticism, who resort to sniveling about anonymity.

It is not about agreement, or disagreement, but about getting ideas out there to move medicine, and EMS, forward.

By the way, I seem to have pointed out that anonymity is traditional. Darn, I wrote something positive about tradition.

Anonymity IS free speech.

Free speech is progress. Obstructing free speech is bad for patients.

Lead, follow, get out of the way, . . . .

Creative destruction is progress.[4] Without creative destruction we would not be communicating with computers (and your cellular phone is often a computer).


[1] A blogger outed
Captain Chair Confessions
September 7, 2012
By the anonymous CCC

[2] Federalist Papers

[3] Anti-Federalist Papers

[4] Creative destruction


Supraventricular tachycardia induced by chocolate – is chocolate too sweet for the heart?


Apparently chocolate, which is an adenosine antagonist, has the potential to cause arrhythmia.

Actually, the methylxanthines in chocolate are the adenosine antagonists (theobromine and caffeine), but it is the theobromine that appears to be what we (I) crave about chocolate. Should I give up chocolate or get an implanted defibrillator? While there is also caffeine in chocolate, only wimps get addicted to caffeine. That headache is just because people are more annoying without caffeine. The caffeine consumption is completely under control.

An otherwise healthy 53 year old woman consumed a lot of chocolate. The amount is stated to be a box, but we chocoholics do build up a tolerance.

Electrocardiogram showed supraventricular tachycardia at 165 beats per minute, which was restored to sinus rhythm after adenosine bolus injection.[1]


6 mg?

6 mg followed by 12 mg?

6 mg followed by 12 mg followed by another 12 mg?

We don’t know.

Image credit.
And throw in a six pack of adenosine,
A man’s got to know his limitations.


My inner woman has an old soul, so we gots to know – are we endangered by the chocolate I am currently consuming in supratherapeutic quantities?

While it may be easy to have too many medics, it is blasphemy to suggest that one can have too much chocolate.

Electrophysiology studies showed atrioventricular nodal reentry tachycardia, which was treated with radiofrequency ablation.[1]

A conduction abnormality that was previously undetected? And it is blamed on just a few dozen pounds of chocolate?

The family stated a box of chocolate, which they considered to be a lot, but the family may be unenlightened, when it comes to chocolate.

There are occasional case reports describing association between chocolate, caffeine, and arrhythmias. A large Danish study, however, did not find any association between amount of daily caffeine consumption and risk of arrhythmia[1]

Clearly this is propaganda paid for by Big Caffeine!

Vitals were temp, 98.0; pulse, 150 beats per minute; blood pressure was 87/57 mm Hg; respiratory rate, 25 breaths per minute. Electrocardiogram showed paroxysmal SVT at 165 beats per minute (Fig. 1).[1]

Click on images to make them larger.

Patient was later transferred to the cardiac electrophysiology laboratory of New York Methodist Hospital. Protocols included decremental pacing and programmed stimulation; AV nodal reenterant tachycardia was easily induced and reproducible.[1]

I suspect that the rhythm was induced without chocolate. While the chocolate may have been a contributing factor, this does appear to be an interesting possibility, rather than a effect that has been demonstrated.

I may be more likely to have palpitations when anticipating chocolate, than after consuming that nectar. After all, I’m just trying to get well.

The authors also mention that research suggests that moderate amounts of chocolate (not enough chocolate) can be good for the heart.

A recent study published in the European Heart Journal showed that chocolate
consumption of about 7.5 g/d was associated with a 3.9% lower risk of myocardial infarction and stroke [1]. The risk reduction was attributed, in part, to lowering of blood pressure. Much of the benefits are attributed to flavonoids in chocolate with release of nitric oxide, lower blood pressure, and improvement in platelet function.


Hello dark chocolate, my old friend.


[1] Supraventricular tachycardia induced by chocolate: is chocolate too sweet for the heart?
Parasramka S, Dufresne A.
Am J Emerg Med. 2012 Sep;30(7):1325.e5-7. Epub 2011 Aug 25. No abstract available.
PMID: 21871761 [PubMed – in process]

Parasramka S, & Dufresne A (2012). Supraventricular tachycardia induced by chocolate: is chocolate too sweet for the heart? The American journal of emergency medicine, 30 (7), 132500000-7 PMID: 21871761