Tonight I'm spinnin' a little Son Volt and sippin' 15 year old Macallan...and needing a break. I got some time off last week to prepare for my Board exam which was last Thursday. Prior to that I had about the worst two weeks that I've had in my new employment. Gone are the County days, and while I saw more than my fair share of critically ill, the community ED is a melting pot of critically ill trauma, pediatric and geriatric patients that you don't get in the compartmentalized world of tertiary care medicine...and I have a black cloud. I walk through the door and the shit follows.

For the better part of the two weeks, I was working the early shift which means I'm on my own. Start at 6, the EMS radio usually goes off around 7 with the first nursing home run of the day (hey, it's bed check) and we're off and running. Most of it comes down to pattern recognition or plug the holes as they arise, a sort of paint by numbers approach. Occasionally, you get the, "I know this patient looks bad, and I know this real subtle ECG finding is bad, but I can't articulate why because I have two other critically ill people to take care of" to the cardiologist who grudgingly takes the patient to the cath lab only to find a horrendous blockage in the left main coronary artery and the man needs a bypass, not a stent. I've earned some street cred for later.

Occasionally, a real sick child comes in. And sphincter tone increases. Kids don't get sick and when they do, you need to act fast. Seconds and minutes matter. They will compensate for awhile, but once the start to slip, the decline is precipitous. This baby was working real hard to breathe and didn't even move while the nurses were getting in the IV. I had intubated her and with IV fluids running and antibiotics within ten minutes of hitting the door. She was maintaining her blood pressure and being mechanically ventilated. Stability...or so I thought. As the lab results came back, it seemed to be more than RSV bronchiolitis, perhaps an inborn error in metabolism, diabetes...I don't know. Nothing fit. She was transferred out after I spent another two hours trying to work it out in consultation with a neonatologist and the peds ICU at the accepting hospital. Two days later, she was brain dead. No autopsy. I would like to know if I could have done anything differently, but now it's a lost opportunity. Ten fingers, Ten toes and twenty-one holes?

The break did nothing to change my luck. The black cloud has followed for the past four days culminating in Monday, the busiest day of the week. I seem to attract the nursing home patients with the Do Not Resuscitate order that is mysteriously absent from the nursing home chart only to be found after I've intubated the patient, put in the central line and admitted to the ICU. Unbelievable. Today I was 1 for 2 (thankfully, the hospice nurse poked her head in at the right time to save me from batting 1.000).

I was at a funeral for a friend of mine and got together with some high school buddies that I hadn't seen for awhile and my old cross county/track coach who was like a second father through my high school years, and he asked me if I take the work home with me. Well, I certainly don't take it, I would rather leave it behind, but sometimes it follows me. Cheers.

Assume that all the nations of the world fulfill their obligations under the Kyoto Protocol (they won't!), which reduces global emissions about 5% below 1990 levels. That results in a "savings" of global warming of 0.07Cº by 2050--an amount too small to measure, as global temperatures vary on their own about twice that much from year-to-year.

Assume that all the Kyoto countries adopt -- and fulfill -- MS 2191. The amount of saved warming in 2050 is around 0.11Cº, and about 0.20 in 2100. Too small to measure. The accumulated cost? Probably in excess of 10 trillion dollars.
Source: Cato

...

The Electric Power Research Institute in Palo Alto, California, calculates that even if the US, Europe, and Japan turned off every power plant and mothballed every car today, atmospheric CO2 would still climb from the current 380 parts per million to a perilous 450 ppm by 2070, thanks to contributions from China and India. (Do nothing and we'll get there by 2040.) In short, we're already at least lightly browned toast. It's time to think about adapting to a warmer planet.
Source: Wired

...

Poland has joined Germany in calling for industry exemptions to EU climate rules as a recession in Europe's major economies is casting doubts on whether Brussels will be able to push through its ambitious CO2 reduction programme...

Member states are getting nervous about asking their industries to pay more for CO2 pollution, says Christian Egenhofer, a senior researcher at the Centre for European Policy Studies (CEPS) in Brussels. The "assumptions have gone", Egenhofer said in reference to likely declining investments and growing constraints on governments' abilities to use macro-economic instruments towards 'green' aims.
Source: EurActiv.com

...

Even though it is impossible to argue with a religion, keep these thoughts on file for when you are exposed to the enviromentalists' bupkis.

I'm pretty sure that less than half the riders will get this.

I don't know about you, but i sure can remember registering for the draft. It was easy. You filled out a form you received in the mail and mailed it back. Easy as 1,2,3. Or for someone i know, you actually had military personnel stop by your house and assist you in filling it out. Either way you did it doesn't matter, for what did matter was that you registered. You did your small patriotic duty, if you believed in it or not, knowing full well that our Armed Services are completely voluntary. What about our future President? We know, especially after this last Presidential Campaign, that Barack never was in the Military but must have at least registered for the draft after turning eighteen. Right? Or did here? Well, you decide if he did or not? Or should i say, when did he and did he do it legitimately?

http://www.debbieschlussel.com/archives/2008/11/exclusive_did_n.html

Sorry, I cannot gather enough composure for a measured response to this fetid spew.

The current retirement system, Ghilarducci said, "exacerbates income and wealth inequalities" because tax breaks for voluntary retirement accounts are "skewed to the wealthy because it is easier for them to save, and because they receive bigger tax breaks when they do."

Lauding GRAs as a way to effectively increase retirement savings, Ghilarducci wrote that savings incentives are unequal for rich and poor families because tax deferrals "provide a much larger 'carrot' to wealthy families than to middle-class families -- and none whatsoever for families too poor to owe taxes."

GRAs would guarantee a fixed 3 percent annual rate of return [note to riders: a return would mean that you would actually beat inflation], although later in her article Ghilarducci explained that participants would not "earn a 3% real return in perpetuity." In place of tax breaks workers now receive for contributions and thus a lower tax rate, workers would receive $600 annually from the government, inflation-adjusted. For low-income workers whose annual contributions are less than $600, the government would deposit whatever amount it would take to equal the minimum $600 for all participants.

In a radio interview with Kirby Wilbur in Seattle on Oct. 27, 2008, Ghilarducci explained that her proposal doesn't eliminate the tax breaks, rather, "I'm just rearranging the tax breaks that are available now for 401(k)s and spreading -- spreading the wealth."

No shit? Ghilarducci must have been taking talking points from President-Elect Obama.

Ghilarducci said, "humans often lack the foresight, discipline, and investing skills required to sustain a savings plan." She cited the 2004 HSBC global survey on the Future of Retirement, in which she claimed that "a third of Americans wanted the government to force them to save more for retirement."

Umm, actually, I think a third of the Americans want to have more handed to them when they retire, and they are willing for it to be stolen from their neighbor. That same third believes that the cash they would give the all-knowing and resourceful government would be in the GRA account when they do retire. If Karlin's half are dumber than the average (he should have said median) idiot, then Ghilarducci's third are complete morons.

It gets worse...

"Moving to refundable tax credits for promoting socially worthwhile activities would be an important step toward enhancing progressivity in the tax code in a way that would improve economic efficiency and performance at the same time," Greenstein said, and "reducing barriers to labor organizing, preserving the real value of the minimum wage, and the other workforce security concerns . . . would contribute to an economy with less glaring and sharply widening inequality."

Progressivity you say? I guess having the top 5% of earners in America paying 95% of the tax load is not progressive enough. What this country needs is reduced barriers to unionization (see also: auto industry bail-out), real wage fixing value and more employer-based incentives.

Just remember, when you are ass-up with the Fed's weight behind you, you paid him to do it. He told you he was going to do it. And you still didn't think you were going to get fucked in the name of patriotism.

If you haven't been there in a while, the Mint Inklings page has been updated. Feel free to tag-in on the markets the riders are trading in.

Said another way:

Also worth noting: CNN: 2008 Exit Polling.

RCP: Bailout Nation? Obama & The Big 3.

The bailout would be of the United Auto Workers as much as of the automakers. It's the UAW that saddled the Big Three with unsustainable labor costs and obligations to retirees. Detroit has desperately been trying to get out from under this burden, but Ford still lost $1,467 per vehicle in 2007, while GM lost $729 and Chrysler lost $412. Where the UAW doesn't reign, the industry thrives. Toyota and others profitably manufacture almost 4 million cars in nonunionized states in the South.

The case for the bailout is that the job losses from a GM going down -- 100,000 directly, and many more indirectly -- would be too painful to bear, and the government would be left holding the bag on GM's pensions. This line of reasoning conceives of GM essentially as a job programs and welfare agency.

Lowry nails the issue on its head. See, the problem with the American auto industry is two-fold. Since the energy crunch of the 1970's they have not been able to keep up with foreign competitors and produce vehicles that people want to drive. Outside of the trucks and sports cars, there is little enthusiasm behind a domestic car purchase. Sure, you may be driving a Pontiac, Ford or Dodge, but my guess is you picked it up because it was cheaper than the foreign counter part, you could get better financing, or you felt a patriotic urge to support your fellow citizens. No? The second half of this situation is the UAW. The big three have faced dwindling sales for decades, and have not had the ability to tell the Unions to back-off.

Instead, the auto-industry taps the american tax payer to fund their unsustainable pension plans. Nice, huh? Got a friend or relative that is employed by GM? Grreat. Next time you see them, ask them why you hsould be contributing to his pension plan. Note their response.

Washington Post business writer Steven Pearlstein suggests a compromise: Only commit government funds if the auto companies taking them go bankrupt. A bankruptcy court can reduce the obligations to retirees, make it possible for Chrysler and GM to pare back their unnecessary dealerships, and scale back wages and benefits. Top management should be fired. All of this can be set in a "prepackaged" bankruptcy that won't disrupt operations.

Failure is not pretty, but it does provide valuable learning. If I were a union guy working for the auto-industry, I'd be figuring how I could leave the union. Then I'd be looking for work at the closest Toyota/Honda plant I could find.

Mark Steyn: 'Center-right' America lurches further left

I Disagree with my fellow conservatives who think the Obama-Pelosi-Reid-Frank liberal behemoth will so obviously screw up that they'll be routed in two or four years' time. The president-elect's so-called "tax cut" will absolve 48 percent of Americans from paying any federal income tax at all, while those who are left will pay more. Just under half the population will be, as Daniel Henninger pointed out in The Wall Street Journal, on the dole.

By 2012, it will be more than half on the dole, and this will be an electorate where the majority of the electorate will be able to vote itself more lollipops from the minority of their compatriots still dumb enough to prioritize self-reliance, dynamism and innovation over the sedating cocoon of the Nanny State. That is the death of the American idea - which, after all, began as an economic argument: "No taxation without representation" is a great rallying cry. "No representation without taxation" has less mass appeal. For how do you tell an electorate living high off the entitlement hog that it's unsustainable, and you've got to give some of it back?

In Forbes last week, Claudia Rosett issued a stirring defense of individual liberty. That it should require a stirring defense at all is a melancholy reflection on this election season. Live free - or die from a thousand beguiling caresses of Nanny State sirens.

It's not so much the giant sucking sound that Ross Perot mentioned in 1992 as it is a gradual slide whose inertia is legion and destination is a race to equality.

Sign. Me. Up.

Got time today?

Great. Give Reagan's 1964 A Time for Choosing speech a spin. [transcript]

We have so many people who can't see a fat man standing beside a thin one without coming to the conclusion that the fat man got that way by taking advantage of the thin one. So they are going to solve all the problems of human misery through government and government planning. Well, now, if government planning and welfare had the answer and they've had almost 30 years of it, shouldn't we expect government to almost read the score to us once in a while? Shouldn't they be telling us about the decline each year in the number of people needing help? The reduction in the need for public housing?

But the reverse is true. Each year the need grows greater, the program grows greater. We were told four years ago that 17 million people went to bed hungry each night. Well, that was probably true. They were all on a diet. But now we are told that 9.3 million families in this country are poverty-stricken on the basis of earning less than $3,000 a year. Welfare spending is 10 times greater than in the dark depths of the Depression. We are spending $45 billion on welfare. Now do a little arithmetic, and you will find that if we divided the $45 billion up equally among those 9 million poor families, we would be able to give each family $4,600 a year, and this added to their present income should eliminate poverty! Direct aid to the poor, however, is running only about $600 per family. It would seem that someplace there must be some overhead.

Amen, brother.

For reference, here's a more current look at welfare And, if you have more time than that, a look at recent reform.

This is a prediction of what I think will happen, not what I think should happen:

(Click the pic for the big version. And go here to make your own.)

Digital cross-process C41-E6 : f6.3 : 1/1600 : 10mm