thank you to my pharmacy techs

 

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For those who don’t know, October is American Pharmacists Month.  While I am happy to take this opportunity to pat myself on the back for being an awesome pharmacist, I’d be remiss if I didn’t spend some time talking about the fantastic pharmacy technicians I have worked with.  In fact, I should have done this sooner.  Navy pharmacy technicians are the finest in the world, and I would say that I have worked with some of the best of the best.  The photo above was shot just last week at an awards ceremony where one of my previous pharmacy technicians was recognized as the top senior technician in the Navy.  Mr Vogel came to me as a new technician straight out of school.  Now with a number of duty stations and advancements behind him he is recognized as the best in the Navy.

Mr Vogel (now HM1 Vogel, but then HN Vogel) is just one example of the high quality medical experts I’ve had the pleasure of working with.  I won’t list them all out for their privacy, but you know who you are.  My technicians from Corpus Christi (my first duty station) who helped me to grow as a leader and helped me learn the Navy system and those in Rota who performed well beyond their experience, thank you. A lot of leaders have said they learned more from their staff than the leader could have ever taught, but for me this is especially true.  Exceptionally brilliant technicians challenged me at every turn, with thoughtful questions and innovative ways to do things.

One particular trait I found in the technicians I have worked with, is the desire to always find a better way.  Part of that comes from each of our own desires to make life a little easier, but, more often than not, these technicians were seeking to provide a better experience for our clients.  I know that the nursing and physician staffs would agree that the pharmacy technicians have made the difference in the treatment of our patients.  They have been attentive and helpful; even when they didn’t necessarily want to be making that IV in the middle of the night.  The knowledge and skill sets of these technicians has rivaled many pharmacists, and the technicians’ ability to apply it daily saved lives and made people healthier.

There have been some bumps on the road, but the pharmacy team stood strong.  I have always admired my pharmacy technicians’ resolve when things went wrong.  Whenever the going got tough, the team would band together and cover extra hours, or work harder to get the job done.

Working pharmacy is a difficult job.  You hear a lot about what’s going wrong, but don’t get many compliments when things are going right.  I can tell you over the course of my career we have filled 10’s of thousands and probably 100’s of thousands of prescriptions together.  The number of compliments rarely outweighed the number of complaints, but take that number into account when considering the undertaking.  Each  technician should be proud of the work accomplished and the accuracy, efficiency, and attitude with which he or she accomplished it.

Many of these outstanding individuals have gone on to other tracks in life.  Civilian careers, entrepreneurship, or schooling.  To those technicians, thank you for serving.  You have done a great service for your country, and the Navy is better for your service.  For those who are still with the Navy, continue to do great things and show the world how great you are.

You, pharmacy technicians, have made me a better leader and I’m thankful for what you do.  Keep up the great work in whatever you do. I can’t wait to work with you again!

alright we need to talk about this time travel thing

I spent some significant time the other day, talking with my wife about the impacts of time travel.  I’m not sure how the conversation started anymore, (Isn’t that how most great conversations start?) but we ended up discussing the impact of changing history, and how it would affect the future.  Luckily, she is married to a trained theoretical physicist, with advanced degrees in time theory.  (Sidebar: I took physics I and II in college.)

To be clear, this is only my opinion, but after considering it thoroughly, I’m convinced that I may have developed a new theory on time travel that will soon be galvanized in text books.  Given the impact of this discovered theory, it was clear that I must immediately construct a half-cocked blog post that may be read by dozens of people.  (I’m assuming that Science magazine will just plagiarize it from my blog for their next edition.)  My intent to document this revolutionary idea in the annals of history with a dedicated blog post was backed by the steadfast support of my wife. “You’re not going to write about this for your blog, are you?”

With that cleared up, here’s my earth-shattering hypothesis in one statement: it’s not the magnitude of the change you make; it’s how long ago you made it.  Did that just blow your mind?  In advanced physics, we’d write that as mind = blown.  I know that the more scientific among you will require a scientific proof.  I could provide that to you, but instead here are some colorful examples.

First off, for this to be at all possible, we have to accept that time travel into the past is possible.  Now, there are a number of things in physics which say this might not be possible.  I think that if we can believe that Arnold Schwarzenegger can travel through time as three different robots, with three different personalities, and then later actually in real life become governor, then time travel is the most reasonable part of that scenario.  So, we’re assuming a person can travel back in time.  Point proven.

We also must assume that time is linear, for this example.  In other words, if you changed something in the past, then it could impact things in the future.  There are people who believe that changing the past will create a separate parallel universe, which will exist along side the universe that existed before the person went back in time.  These people are wrong.

So, now that we’ve got the ground rules established, here are the two scenarios that prove my theory:

1.  You go back 25 years, and invest in Microsoft. (Is that far enough back that they’re still relevant? (Don’t laugh, Apple people – you’re next.))  You make a reasonable investment that would today make you quite wealthy.  Unfortunately, by that action you’ve taken the stock off the market, and, therefore, prohibited someone else from buying it.  So now the person that would have been rich, will not be rich.  Instead they will end up working for living, which means that your Dad couldn’t get the job that person occupied, which means that he couldn’t buy your Mom an engagement ring, which means they didn’t get married, which means you weren’t born.  You see the large amount of effects there?

2. Now imagine if you went back to yesterday, and made a massive investment in a small cap stock that went up 20% miraculously, overnight. That would be a much large impact than your modest investment of 25 years ago, but the outcome would be the same.  A lot of money would be yours today.  What didn’t happen was the time to allow 2nd and 3rd order effects to occur.  Sure, you can assume you have somehow changed the future, but that future hasn’t happened yet, so who cares.   Unless you’re one of those people that believes that the past, the present, and the future all exists simultaneously.  Of course those people are wrong.

So with that, I think I’ve conclusively proven that it’s not the magnitude of the change that you make; it’s how long ago you made it.  I’ll gladly accept my Nobel prize at the committee’s earliest convenience.

P.S.  Anyone with a movie example that can prove my theory wrong gets an honorable mention in my blog.

P.P.S Don’t even bring Back To The Future into this.

P.P.P.S Especially Back to the Future 3.  That movie was terrible.

P.P.P.P.S.  This is the most fun I’ve had writing a blog in a while.

why ebola scares me (hint: it’s not why you think)

It’s not the ridiculously high mortality rate of Ebola that scares me.  It’s not the fact that health care workers are contracting it simply because they’re doing their jobs.  It’s not even the extremely long latency period before symptoms develop.  No, it’s something much more benign, but critically important.

The media has been doing an “exceptional” job of covering the Ebola “crisis” in America.  (I put those two words in there as sarcasm.)  The media has been doing a great job of scaring the public with Ebola, and it’s not a crisis as they have defined it.  There is a public health crisis here on two fronts, but not as reported.  First, the people in Liberia and on other African fronts are truly in a crisis.  Their substandard public health system and the lack of a pre-planned world response to this type of outbreak have set them substantially behind the curve for being able to contain the disease.  The number of deaths and suffering are unacceptable from a human perspective.  Additionally, the lack of public understanding on this issue will lead to second and third order effects in this area.  For example, there is already evidence that food prices are escalating, due to many of the key routes providing medical and humanitarian supplies being cut off.  That is a crisis.

The second crisis is here in America.  We are missing a prime opportunity to prepare for a real health crisis.  (Side bar: Get your flu shot.  More people will die this year of flu in America than Ebola.  I’ll take bets.)  While the American public is being bombarded with images of men in white bio-hazard suits and talk of isolation chambers, we are missing the chance to educate the public on measures that will help in a legitimate pandemic.  The transmission of Ebola is extremely limited (as far as infectious diseases go).  While we have seen diseases with limited transmission have huge impacts before, they are nothing compared to impacts that could strike us in a situation such as the 1918 flu.  Otherwise known as the Spanish Flu, this pandemic wiped out an estimated 8-10% of the young adult population.  For perspective, WHO says the death toll for Ebola today is about 4,000 (an undoubtedly low estimate,given that so much of the affected population is hiding their disease).  The devastation in 1918 was up to 100 million dead.

So what’s the difference between the 1918 influenza and Ebola today?  Most importantly: transmission.  1918 influenza was absurdly communicable (transfer from one person to another.)  Transmission of Ebola today only occurs with contact of bodily fluids.  It is not airborne like the 1918 flu.

Here’s why I’m worried about the the crisis in America.  We’re not using this limited transmission disease to emphasize precautions and hone our response in preparation of a larger pandemic.  Hand washing and isolation techniques are the fundamentals we should be teaching.  While social isolation is overkill for Ebola (handwashing is always important), this is an opportunity to educate the public on a plan for a large-scale highly-communicable pandemic.   We should be teaching our steps for addressing this type of situation.  We’re not closing the borders for Ebola (right call by the CDC), but what situation would need to occur for us to consider that step?  We’re not shutting down schools in Dallas (the #1 impact we can have on preventing highly-communicable disease spread), again this is not something we should do for Ebola.  We should, however, be communicating to the public when we would close them in a pandemic.  I assume that medical facilities are testing their own response plans, but that’s probably something to be emphasized as well.

I understand the public’s desensitization to these alerts.  We’ve had swine flu, bird flu, and any number of other pandemic threats in recent past.  Unfortunately, it’s just a statistical likelihood that we will have another large scale pandemic.  If anything, these previous alerts have shown us how ill prepared we are for a larger outbreak.  The CDC and federal government should use this opportunity to test their communication techniques, and improve their response strategies with the general public.

If you’re interested in reading up on public health preparedness, I suggest The Great Influenza by John M Barry as a fantastic read.

making a sweet rock wall for your garage

For those who don’t know, I’m a huge fan of rock climbing.  I’ve been climbing since I was about 10, and have climbed all over the world.  I really enjoy it as a way to focus and relieve stress.  Probably the thing that’s most appealing to me is that there are no excuses on the rock: you can either climb it or you can’t.

Now, none of this means that I’m a good rock climber.  I’ve climbed some fun stuff, but nothing particularly earth-shattering for grade.  I’m by no means an expert, in that probably the most difficult I can climb is 5.10.  For those who are unfamiliar with rock climbing, vertical climbing difficulty is measuring on an interval scale.  It’s rather subjective, but generally, experienced climbers can consistently rate how difficult a climb is.  It’s hard for one to understand how it scales, but if you want to know more you can check out the wikipedia entry.

Despite my lack of extreme talent in climbing, I am good at teaching and know the safety of rock climbing well.  Since it has been such a passion for me, I want to help my kids enjoy this hobby as well.  They’re all quite excited about it whenever we go out on the rocks, and are actually pretty decent climbers.  They have a problem with the heights, but their mechanics are pretty good.  My daughter can almost certainly outclimb me, and my oldest son has very good technical ability.

To further encourage their interest, I decided it would be fun to build an indoor climbing wall.  I’m not going to step-by-step it here with all of the technical details, but I’ll provide some basic guidance, in case others want to try it.  If you’re looking for more advice, please let me know and I’ll be happy to help.

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First thing you need is a clear space.  It’s hard to get an idea of scale in this picture, but it is about 10 feet between the saw horses on the wall and the corner.  Floor to ceiling is 12 feet.  If you don’t have a finished garage, this is a much easier project, as you can anchor your framing directly onto the wall studs and ceiling joists.

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Here’s the wall framed out.  I anchored a 2×8 to the wall and ceiling, and used joist hangers to support the 2×6 frame.  Took a considerable amount of work, but the completed project is rock solid.  I tried to push this off the wall and couldn’t.  That’s good, because it hangs 3/4 inch sheets of plywood off of it, which aren’t light.  Also it’s going to be holding people, so I wanted to make sure it couldn’t come down.

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I am not using a rope and harness system, so my wife and I made this crash pad.  We used 5 foot width fabric and made a 5′ x 10′ x 1′ pillow case.  We then bought foam scraps online.  Below is the photo of what the foam comes shipped like.  On the right is a package that hasn’t been opened.  The pile is what happens after you open the package.

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After the pillow was done, I drilled, anchored, and hung the plywood.  This is a painful process, as you end up drilling a lot of holes and spacing them is tedious.  Once is done, though, it’s a simple process of bolting your holds on, and you’re ready to climb.  Here’s the first complete assent.

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The kids love it that, once you complete a new route, you get to give it a name.  The first route on the wall was “Hard Fall.”  I rated it at 5.7.