ECMCRT! ECM Crisis Response Team!

ECM Field Journal #9-Residency Opportunities in Clinical Medicine!

Fri, 29 Feb 2008 05:43:49 GMT

Well it's official, I have decided to heed the calling and do a residency in Clinical Medicine at the prestigious Embracing Clinical Medicine Research Institute (ECMRI). It took me 4 years of medical school, but I have realized that medicine on a whole has failed the world's population. I am rejecting their ideals and paving a new path with the ECMRI-just take a look at the information they sent me and you'll see why you should join them too.

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Dear Applicant,

Thank you for you interest in the Embracing Clinical Medicine Research Institute. The ECMRI has a rich history and proud tradition. Founded in Puerto Rico in 1998 by the father of clinical medicine: Hilliary Clinton, the ECMRI and its affiliated hospital: St. Jimmy was initially started as a clinical entity to test pilot Ms. Clinton's universal health care plan. After 3 weeks, numerous riots, 400 deaths, and a new strain of Leprosy that causes Herpes and Cushing's disease, the US government disavowed all knowledge of the facility and left it abandoned. It was abandoned until 3 homeless people (who coincidently also had PhDs in psychology) decided to squat in the abandoned building and worked out a deal with judge restore the facility in lieu of jail time for practicing medicine without a license. The ECMRI was founded 2 years later after public health officials and building inspectors mysteriously died from Cushingoid leproherpes disease before filling the court order to have the building condemned.

Flash forward to today-2008-the present

In just 8 short years, the ECMRI has become the world leader in preventative medicine. No other clinical entity in the world prevents more medicine than us.
We have a diverse collection of the brightest doctors from all over the Caribbean researching how to bring medicine into the 22nd century. Just look at some the activities being conducted at the ECMRI

--The first ever External Medicine Residency™

Did you feel that Family Medicine and Pediatrics took a rather hard edge when it came to patient care? Did you feel like those “other” residency programs spent too much time teaching medical facts and talking down to patients instead taking important social and sexual histories or going over your 200 item review of systems checklist? Our patented 8 month External Medicine Residency™ is right for you. We have learned through weeks of scientific research that most medical problems can be cured through the skin, specifically through hugging. By spending 10-15 minutes getting to know the patient through hugging and physical contact, we believe the positive chi escapes from your body and enters the pts body-destroying tumors and untwisting volvuli as it passes out the person’s back, eliminating the need for harmful pills, surgery, or vaccines.

-Objectifying the pain scale
For years the 1-10 pain scale has failed medical professionals in their efforts to accurately gauge the pain their patient is feeling. Top researches at the ECMRI have developed a portable device called the “Fungun™”.

The Fungun™ is designed to be carried around in the physicians coat pocket to allow them to accurately and reproducibly gauge the patient’s pain. The Fungun™ uses an electrical current that is adjustable on a 1-10 scale to accurately help the patient grade the pain they are experiencing. We recommend starting on the “1” setting and moving up until the pain from the Fungun™ matches the patient’s pain. No longer do you have to rush to take an appendectomy back to the operating room! If the patient is complaining of burning, stabbing, or shooting pains-we also have developed a variety of medical instruments to help you patients be able to better identify their pain.

*The Fungun™ is also available in pediatric formulations

-Improving patient’s attitudes toward Prostate Exams-

Since the dawn of time, the male prostate exam has been a cause of emotional trauma for men all over the world. We believe that the same techniques the ECMRI have developed for pelvic exams be followed for prostate examinations as well. Days of scientific research has shown that KY jelly is proven to create false negatives on FOB testing as well as cause physicians to classify cancerous prostates as normal. For this reason, we started the “relaxation is your lubrication” campaign for prostate exams. We believe that by slowly walking the patient through the exam, taking time to explain when your gloved hand touches his thigh and slowly working your had up to the external anal sphincter relaxes the patient for a painless prostate exam. If this does not work, our research has shown other water based lubricants-such as saliva-do not interfere with proper prostate examinations.

-An ingenious way to prevent the formation of infected decubiti

Pressure ulcers are probably a leading cause of morbidity and mortality associated with long hospital stays. Top researchers at the ECMRI have put their heads together for literally hours to create a new type of patient bed that actually can prevent the formation of infected pressure ulcers and other infected skin breakdowns.

UV light kills bacteria, so why not have the patients exposed to plenty of bacteria killing UV light during their hospital stay? We plan to install these new bacteria killing beds in every patient room in St. Jimmy’s hospital within the next 12 months in our new Hawaiian Topic wing.
As you can see, there are plenty of reasons for you to come join the ECMRI and only a couple of reasons for you not to. Join our external medicine residency program and learn to become a world leader in the field of clinical medicine (just don’t forget your valtrex and dapsone)!

ECMCRT! field journal entry #5-ECM in Court

Tue, 14 Feb 2006 05:19:40 GMT

This latest field entry comes from Dr. Harvey Kelekian R.N., who is a born-again crisis response teamer since 2004. I hope his story is as life-affirming for you as it was for me.
Sincerely,
DTM-your ECMCRT! local field agent response coordinator

Hello fellow ECMCRTers!
My name is Dr. Harvey Kelekian, R.N. and I want to tell you a story of a life torn asunder, and how I was saved in the healing glory of ECM! 6 years ago, I lived a rich and decadent lifestyle as an internist at a teaching hospital in Florida. I taught students, published papers, drove a sweet car, and my game with the ladies was as strong as ever. Life was good to me.

That all changed one day though when I took in a terminally ill ovarian cancer patient into my service to try a new method of radical chemo and radiation treatment I had developed to slow and hopefully eradicate the cancer spreading through her body. At first, things were going swimmingly, that is until the patient kept trying to talk to me and stuff when I was in the room taking readings and measurements of her for my research paper. I couldn't stand it when patients try to make small talk with me, can't they see I am a busy man and have lots of sick patients to take care of?

This went on and on for days, despite my constantly ignoring her. Finally I decided it was time to settle this...so I brought in some medical students. If you have ever seen the movie Willard, medical students are the rats that under my control. They smell bad, will eat anything if it’s free (it doesn’t matter who pays for the pizza), and they will do anything I ask them to. They poked and prodded and percussed my patient like they were making sure they were getting the best cantaloupe from the farmer's market. Surely, I thought this would be the end of her chatty behavior.

Oh but it wasn't...in fact, it only got worse.

The next day when I came in to get my readings she had a stack of freshly penned anti-doctor feminist hate poems which she read aloud to me. I tried to work quickly as she read "my spirit goddess will rip you to shreds once I get better! Then I will have the last laugh..........just like Eddie Vedder!"

This routine from my pt continued every day. One can only take so much of this before it to really gets into your mind. As I saw myself becoming short tempered with my other patients, I knew just who was to blame for all of this. She didn't appreciate all I was doing to save her life, she complained every time I walked in the room, and to top it off...she was a MEDICAID patient!!!! I was barely getting paid for this!!!! Drastic actions had to be taken.

Once night, while the patient was asleep, I slipped into the room and replaced her Chemo IV with an IV of 1000 cc's of Mountain Dew. I quietly slipped in 2 pouches of Xtreme Sour Apple Pop rocks into the bag and left the room to wait for the code to be called.

Three minutes later, I was back in the room...I had nearly slipped on the trail of blood left by her kidneys as they had shot 15 feet across the room and splattered against the wall. I thought I had just committed the perfect crime, she had no family or friends that visited her, no one would care enough to inquire into this little mishap. It wasn't until 3 days later that I realized I forgot to take 1 minor detail into account, and it wasn't long before it came around to bring me down…

….She wrote anti-doctor feminist hate poetry about spirit guides….

How could I have been so stupid! I should have known...it turns out she had deep ties with our university’s ECM department! They brought in their best men to investigate the scene. Immediately, they began with a behavior change intervention on the patient. Turns out she was in pre-contemplation about being dead and wasn’t about to change her mind anytime soon. Some of them left pamphlets and a diary for her to write about what times of day she felt more deader than others.

Eventually it all came back to me, especially since I had my medical billing dept code in ICDM code 702.81: “mountain dew/pop rocks euthanasia IV drip” on the pt’s bill. I was brought to trial and was prosecuted by the nation’s most feared ECM trained malpractice lawyers/doctors, also know as “the wagwraiths” lead by the terrifying Gippy P. Longbottom! I had heard about them through medical myth and legend, they were physicians by training that “exceeded expectations”. They were kidnapped and large portions of their brains were removed until they were convinced that ECM teaches the only correct way to work with patients. With most of their brains removed, they were now content with being malpractice lawyers.

I was called to the witness stand and the judge had me sign the honor code.

The prosecution laid out their plan of attack, but instead of focusing on the fact that I brutally murdered my patient (which they only mentioned in passing), they played up on the fact that I didn’t listen to the patient’s small-talk or take the time to fully digest my patient’s anti-doctor feminist hate poetry about spirit guides and Eddie Vedder. I heard one juror whispered “my doctor on average only allows me to 18 seconds when asking me what brought me there today!, that’s barely enough time to tell him I need another Viagra prescription!”

Gippy P. Longbottom cleared his throat, “what I am about to show the members of this court is ECM’s MOST SACRED DOCTERINE!” It is the cornerstone of all that we believe in, it teaches all physicians explicitly how they should conduct themselves to patients, and only a few dozen humans have EVER SEEN IT!

Gippy got on his knees, bowed his head and raised an object as high as he could with both hands. I gasped when I saw what Gippy was holding. Clenched in his hands was a dust covered VHS copy of the made-for-TV movie WIT that was purchased for 25 cents from the local flea market (as evidenced from the price tag still affixed to it). Gippy played the tape for the jury, and as they wiped the tears away at the end of the movie, their eyes replaced these tears with boiling hatred toward me.

“As you can see in this real-life dramatization, doctors DO NOT CARE ABOUT PATIENTS!”, Gippy exclaimed. “They only care about their ego, money, and results for their research papers! Ladies and gentlemen, I hope you can see my way about what we must do about the defendant, Dr. Kelekian.”

“As evidenced by the movie, there is only one way to get egocentric patient-hating doctors, such as this one before you, to care about patients.”

I saw a wry smile form on Gippy’s face “And that is to make him a nurse.”

I jumped out of my seat, roaring laughter until tears were streaming from my eyes. “You lose Gippy! I already have my M.D., I’m not dumb enough to be a nurse!”

The smile never faded from Gippy’s face “Ladies and gentlemen of the jury, if you relinquish control of this deviant physician to me, I assure you he will return to you not as the man he once was…but as a nurse, the only medical “professional” that actually cares about patients."

The jury found me guilty and I was turned over to ECM protective custody. I was immediately flown out to their secret underwater base located off Guantanamo Bay (Ed. Note-where the ECMCRT! trains its culturally conscious commandos-see field entry #3). I was handcuffed and shackled and brought to a dark interrogation room and sat in front of a single bright sodium light shining directly onto my face.

Out of the corner of my eye, I saw the reflection of the light as if it caught someone’s eyeglasses and heard a cool female say “give him the tests”. Two packets and a #2 pencil were placed before me. The first of the packets read “NCLEX- National Council Licensure Examination for Licensed Practical/Vocational Nurses”…and the other test was labeled “ECM test #2”. I could hear a gun cocking from the darkness and my hands were freed from the handcuffs. “Begin your tests” said the cool female voice from the corner.

After 2 hours, I had completed both examinations and had submitted them. “What were his scores?”, said the cool female voice in the corner. “100% on the nursing licensing exam and 8% on ECM test #2” said the gruff voice of a man. “Do it”, said the cool female voice.

Before I could register what was happening, two fat, toxic smelling permanent markers were shoved in both of my nostrils. As I began to panic, a plastic bag that contained nothing but turpentine fumes was placed tightly over my head-choking me. A tray slid into view through the moisture-covered bag. On this tray was 3-dozen mercury-containing, autism-causing vaccine shots that are now illegal in our country. "NOOOOOOOOOOOOOO!!!!!!!" I screamed before the blackness overcame me.

I awoke in a daze, feeling much more bubbly and fuzzy than before. The same 2 test booklets were placed in front of me and I was forced to take them again, although this time it took me 10 times as long to complete. I had made half of a test book into a decorative paper hat, and I ate at least 6 of the #2 pencils.

“Scores?” said the woman in the corner. “70% on the nursing certification exam and 100% on the ECM exam” said the gruff manly voice. I could feel my shackles being released. “Congratulations Mr. Kelekian, you are now a registered nurse. You are free to go."

Now I’m soooooooooooooo glad now that I accepted ECM into my life. I even got a job at the place I used to work before at 1/35th my original salary! Now that I am a nurse, I take all my patient’s feelings into account and give them the compassion and cuddly caring that can only be given by ECM practicing nurses! I’ll never leave a patient’s bedside with them feeling glum, even if they call a code or bring in busload of people from a natural disaster! Sure, sometimes I get so caught up in an interesting conversation with a patient that I forget to do little things…like match up blood types, but I have other things to think about...like where I can get matching pants for that cute Sponge Bob Squarepants top I bought yesterday! Thank you ECM for showing me the WIT way, and supplying me with all the #2 pencils I can eat!

Mission Statement of ECMCRT!--READ ME FIRST!

Tue, 10 Jan 2006 17:27:49 GMT

You are driving to the clubs downtown on Saturday night and you witness a car accident. The driver wraps his towncar around a tree. You immediately dash to the scene and observe the situation. Gas is leaking from the car at a rapid rate and is likely to combust at any second. The driver is unconscious and deep cuts with uncontrolled bleeding from windshield glass cover his face and extremities. According to his medical bracelet, he has a clotting deficiency as well as congestive heart failure. You also smell the odor of alcohol in the car. On his other wrist is another medical bracelet to say he is diabetic, and according to his insulin journal, he hasn't had his last injection of insulin. From the looks of the scene, the man was trying to give himself the injection before his accident.
What is the best thing you can do in this situation?

A)Call 911, Stabilize the pt's back and move him from the car before it potentially explodes

B)Control the pt's bleeding and stabilize him as best as you can, call 911, and ask for further instruction.

C)Give the man his insulin injection first.

D)Attempt to rouse the patient to assess for a positive family history of alcohol abuse, then perform a behavior change intervention.

In any given situation: there's a right way to do it, a wrong way to do it, and then there is the vastly superior ECM way to do it. This forum is members of the ECM crisis response team! who have used skills learned in ECM to deliver patient care into the clinical nirvana. Welcome to the ECM elite. I will be posting field entries from time to time from doctors and health care professionals that have joined our ranks and have certainly "Exceeded Expectations". If you would like to share a moment where your ECM skills came through in the clutch and inspire us all, please feel free to talk about your experience here!

My favorite ECM moment of 2005

Tue, 10 Jan 2006 17:14:55 GMT

Now that the new years has passed and we are now in the year 2006, I like to reflect a little on some of the finer times of the previous year. When I think back on 2005 and all the ECM goodness we had during that year, I would have my favorite event would have to be procedures lab. To commemorate this occasion, I have written a song for those special days.

If there is anything ECM has demonstrated
Is how poorly 1st years do procedures uneducated
When it comes to procedures I was quite meek
I couldn't even get past proper gloving technique
Busted gloves on hands dripping with fear
I properly massacred a poor pig's ear
I am glad I didn't get a grade
because of the huge mess I made
with time called, my ear was hacked into two
I guess I'll stick to superglue!

Nothing could have prepared me for the final meeting
Nor would my nose repair from that final beating
Drawing blood was bad enough pain
My partner would not restrain from finding a vein
Like an SUV in an accident my vein rolled and rolled
And he kept digging like he was mining for gold!

All and all, The NG tube was the worst
Why can't we practice on the homeless first?
Drug them up, bring them here
keep them in storage all through the year
then when it is finally time
my classmates ram a tube up their nose instead of mine
Gagging, choking, bloody napkin
Is this what's supposed to happen?
It was so awkward, as far as awkwardness goes
there is nothing so awkward as bringing your lunch back up through your nose.
Exhausted, in pain, and thoroughly sweaty
I pulled the tube out my nostril like plastic spaghetti
Looking back on the day, I thank god I'm alive
I will never forget Nasal Rape Day 2005.

ECM field journal entry #4-Make a baby, the ECM way!

Tue, 29 Nov 2005 03:44:51 GMT

Here is another shining example of using ECM to solve another crisis situation, from Fahey Davis, a second year medical student at Mercer.
Your Pal,
Captain DK-ECMCRT! Field Agent Coordinator

Dear fellow members of the ECMCRT!,
During my 2 years in medical school, one thing I have learned is how utterly negligible all the various facts and doo-dahs you learn in the first 2 years really are. When you are in the field, and crisis strikes and you are called on by your fellow man and peers to get in there and kick some ass, knowing about the tetralogy of fallot isn't going to cut it. Only things like your elite ECM training stay with you, seared into your soul. Unlike the outdated "traditional" medicine approach to solving medical problems in a paternalistic way with a harsh drug regimen, our ECM training allowed us to open our eyes and minds to traditions and customary medicinal therapies of other cultures. This way when we see patients of different backgrounds, we can give them the broadest spectrum of treatment possibilities.

Recently my duties were called upon to solve a problem that was above my head as a 2nd year medical student. After eating out at the Golden Buddha with my girlfriend one night, we were on a moonlight stroll to catch a late movie when a rather portly, standardized African-American woman fell down in front of me and started screaming. Springing into action, I ran to her side and yelled at her "Do you have insurance ma'am?" She nodded her head no; I grabbed her purse and evaluated her financial status-3 MARTA tokens and a coupon for 25 cents off Land O' Lakes butter. I stood up and got ready to leave, but I remembered that I just so happened to have an emergency Medicaid application form in my pocket. I had her fill one out and being the Good Samaritan that I am, proceeded to treat her, despite only about a 70% chance of getting paid. After a world class 70 minute history and physical, I determined that she has been having severe abdominal pain for 5 hours, which was preceded by a sudden '"watery" discharge, she has not have her whooping cough vaccination, she drinks sweet tea, and has a strong family history of hypertension, cancer, and diabetes and is in her 40th week of pregnancy. I sit on the sidewalk and put on my thinking cap. It was really hard to think, because the lady kept shouting "baby! baby!" which I figured must be due to delirium caused by head trauma after she fell on the sidewalk causing her to sing Motown songs from the 60's.

ECM teaches us to treat the patient as an individual: and to disregard preconceived notions about race, gender, or sexual preference. Taking that into consideration and using my knowledge I gained from studying for multiple choice exams, I decided to order a CBC to evaluate her for sickle cell disease because the fact that she is African American and since she bothered to include that in the patient description of herself it's pretty much obviously going to be that. So I drew her blood with a needle I found on the sidewalk and dropped it in a mailbox for the lab at Mercer to analyze. I told her I would be back in 24 hours and to "wait here". After a record cold night, I got the results back from the lab and found out that she didn't have sickle cell at all and her oxytocin levels were through the roof. I consulted Mosby's where I was able to narrow my differential diagnosis down to "having a baby right now". If only I had ordered more tests to start with, I could have come to that result much quicker!! I ran back to the patient but when I got there, I realized something.

"I don't know how to deliver babies ma'am, but using the power I've gained from years of ECM training, I'm going to try-now sign this waiver!"

Signed waiver in hand, I got to work. I summoned my vast knowledge of far Eastern alternative medicine I learned in ECM put it to use. I pulled the fortune cookie I had been saving in my pocket from the Golden Buddha the night before and with steady hand broke it in half and calmly read the fortune to myself.

"Listen to what surrounds you; it will tell you what you need to do to be successful.

Your lucky numbers are 3,35,52,71, 88, 93"

I look away from the fortune, stunned. I ate the cookie and thought to myself, "what sort of cryptic message is this!?!?!" Then I recalled from my ECM cultural competency tests that Asians speak only in obscure metaphor and riddles. I remember getting a question on an ECM test back in my first year.

“An Asian mother comes into your office and asks if it is safe for her infant to take Tylenol for fever, keeping in mind that she is Asian, what should you say in response?”

A)Absolutely not, their livers are not mature enough to handle Tylenol yet, try a cold compress on her head instead and wait for it to subside.
B)I can see you are concerned about your child, I understand, but it is not healthy to give an infant Tylenol.
C)When the Koi swims upstream to spawn, it is better to attract it’s fancy with your finest prawn, only then will Lucky Cat make good lifelong fortune of spicy chicken.

Clearly the answer is C, because the mother really didn’t have an infant! That’s how Asian women ask their doctor about acquiring birth control (aspirin for the baby) because it’s such a touchy topic in their culture, answer C says “Yes, I will prescribe birth control (a.k.a. spicy chicken), make sure to take it at the same time every day (finest prawn) to prevent pregnancy (Koi swimming upsteam).

It was especially hard to concentrate on deciphering the meaning of the puzzle when the patient was screaming "I am a nurse practitioner, I know exactly what to do...I am having a child RIGHT NOW, all you have to do is listen to my instructions and help me out and this will be easy". I sat up and stared at her, these did not sound like the random ramblings of a woman in delirium. Perhaps she was telling the truth and she really WAS a nurse practitioner. My eyes lit up and a broad smile fell across my face, I had figured out the riddle of the far eastern medical advice given to me by the TokyoCo Fortune Cookie Company-and it was so simple and obvious!

I turned to the patient, looked her in the eye and said "That's nice, but you are just a lowly nurse practitioner and I am almost a doctor, so please be quiet."

The solution to the riddle was clear now, I took out my headphones, and set my IPOD to my "80's-90's alternative music playlist" and cranked it up so I wouldn't hear the patient protest—it was go time! During my elite ECM OB/GYN intersession training, I was taught that you can learn how to perform ANY medical procedure by just listening to the hidden messages within popular songs! With the power of ECM, you don't even have to go to medical school to know how to do complicated surgical procedures! I hit play, took a deep breath, and started my genital exam.

Minutes later, the patient was howling in pain, I looked at my IPOD and realized it was playing Tool's "stinkfist", and I had been doing the wrong type of exam in the wrong place. Whoops! I skipped forward to “Wynona’s Big Brown Beaver” [Primus] to make sure I was in the right place this time. Recalling my training, I regloved and set my IPOD to play Evanescence's "Bring me to Life" and began performing a flawless vaginal exam with the obvious instructions given in the lyrics of the song. I concluded that, yes, she was having a baby. Uncertain what to do next, I fast forwarded to the next song, which was Garbage's "Push It" and I instructed the patient to do so. "Come on Eileen!" [Dexy’s Midnight Runners] I shouted, you'll be “rocking the cradle of love” [Billy Idol] in no time!" ‘Where’s your head at?” [Basement Jaxx] I wondered, but as the delivery progressed, I could see the baby's "head like a hole" [Nine Inch Nails]. The pt said she “feels the pain” [Dinosaur Jr.] and was about to “faint” [Linkin Park], so I gave her some "Lithium" [Nirvana] to calm her down and told her “Everybody Hurts” [REM] sometimes!. After some time, I was able to visualize the “man in the box” [Alice in Chains]. I told my patient that “Everything’s Zen” [Bush] and to gather strength from her “Personal Jesus” [Depeche Mode] and do one last “Final Countdown” [Europe] because her “Black hole son” [Soundgarden] was coming out in a second. She finally gave birth to a wonderful “21st century digital boy” [Bad Religion]. I grabbed the child by the feet and “smacked my bitch up” [Prodigy] to make sure it could “Breathe” [again Prodigy]. I handed the baby over to her mom and it was “Just like Heaven” [The Cure], I told her she should name him “Jeremy” [Pearl Jam] I told her to hold him “until it sleeps” [Metallica]. Thanks to my ECM training and the TokyoCO fortune cookie company, Jeremy is still alive today on a respirator can use upwards of 40% of his brain! Shame the mother had to die, but it was from the unforseen consequences of hypothermia, massive blood loss, and a nosocomial infection because I still had bit of chili fries on my hands when I delivered the baby-in other words, there was no way any of it could have been prevented anyway.

-Fahey Davis-ECMCRT! Field Agent