I saw a disproportionately large pigeon outside my window. It would take only 5 of those birds to span the entire width of the A/C unit. That is big.

misc misc

I’ve performed about ten pterygium excisions in the operating room so far, and the biggest challenge I’ve encountered is operating on the LEFT eye. I’d imagine that any experienced surgeon would scoff at this hurdle, but the patient’s nose seems to impede my suturing abilities significantly (I use my right hand for needling driving).  The suturing in pterygia operations involves the medial bulbar conjunctiva, which is adjacent to the nose.

On my first few cases, I used a traction suture on the cornea to help rotate the globe for access. To minimize trauma on the cornea, I now ask my assistant/attending to help rotate the globe with a muscle hook. This is impractical, since most surgeons operate solo in practice. To remedy this problem, I’ve come up with three solutions:

1. Practice more–the obvious solution, but not elegant.
2. Use my LEFT hand to drive the sutures when operating on the LEFT eye. Use my RIGHT hand to drive sutures when operating on the RIGHT eye. Switch hitters in baseball do it, right? While I am not completely ambidextrous, I’m sure that my triple-digit hours playing Quake III and other FPS‘s might have helped my dexterity.
3. Operate only on RIGHT eyes. After all, there are already too many subspecializations in ophthalmology. Why not specialize on just one eye?

Which one is your favorite?

medicine humor, ophthalmology

I got a call from the emergency room several weeks ago regarding a consult for an “exploded egg” in the eye.

“Bullshit,” I initially thought. The ED frequently calls me about corneal abrasions and other minor trauma at obscene hours.

The photo on the left does not do justice to the severity of injury. Apparently, the patient had left a pot of boiling eggs on the burner, and exploded in her face. A shard of eggshell pierced the cornea through the stroma, nearly penetrating through Descemet’s membrane/endothelium.

The eggshell was removed in the operating room the next day. Unfortunately, I did not get to do the operation (but exciting nonetheless).

medicine ophthalmology

I’ve been stuck at the airport gate for hours numerous times waiting for my delayed flight to be cleared for take-off. I see the flight agents typing away at their 1970′s-style computers frantically to rebook stranded travelers. Behind them sits an aging dot-matrix printer churning out airline codes on reams of paper.  Every so often, I hear a muted announcement over the loudspeakers regarding re-routed flights. The passengers, miserable at best, are on their smartphones frantically texting their travel status to friends and family. Some of them sit in clumps near the power outlets to refuel their power-craving gadgets. How could an airport possibly function in such chaos?

In aviation design, there is no room for chance. Every detail serves a purpose. For instance, the design of airport runways required efficiency to the finest detail. Chicago’s Midway Airport is a prime example. Considered the “busiest mile”, the airport roughly consists of a square mile of runways closely surrounded by local businesses. Its longest runway runs approximately 6000-ft, which limits the size of aircraft the airport can handle. A fully fueled Boeing 747 with maximum payload requires a minimum ground speed of 200-mph for a safe take-off, not considering incoming winds. Approximately 13000-ft of runway is needed to achieve this speed. Furthermore, airfields with limited land area implement displaced threshold airstrips.

The area of the runway marked with chevrons is the displaced threshold region. This region indicates that no aircraft is to land directly on that portion of the runway. The designation applies often when noise ordinances or structural buildings prevent a gradual aircraft descent onto the runway from a particular direction. In many cases, the displaced threshold section also offers less structural support than the opposite end of the runway; the ground on which an aircraft touches down must be able to withstand a greater pressure (force / area) than the rollout region.

How the hell does air travel function with airports working the way they do now? It is futile to seek out an explanation. Airports operate the same way our eye clinic does–despite all the mis-scheduled patients, missing charts, absent technicians; all the patients are remarkably cared for at the end of the day.

medicine, misc euphemisms, travel

Netbooks have been the hot new computer gadget in the past year. Despite having 4-year old processor speeds, the sub-10″ laptops serve exactly as their names imply, to “surf the web”. In theory, they are great for carrying around the city to surf in coffee shops. Some of them even have SSDs that replace the standard platter hard drives. Verizon even offers deals that include a free netbook with your broadband packages.

Unfortunately, most netbooks with SSD’s are unusable without tweaking, because of the inferior MLC’s on the controllers (See Anandtech’s detailed analyses). I spent several hours paring down a Compaq Mini 110C before I could surf the web without hiccuping every 5 seconds. Here is a dirty how-to for tweaking your netbook out of the box (assuming you have Windows XP):

1. Install a RAMdisk immediately. I threw on FlashFire. You can also use another true ramdisk software, but it will require tweaking. This will allocate some of your memory (RAM) for use as temporary hard disk space. While counterintuitive, a ramdisk will serve as fast memory for the SSD buffer.
2. Start removing software. Get a cleaner like CCleaner or RevoUninstaller. You can uninstall them after you’re done cleaning house.
3. The goal is to remove as much junkware as possible, like the Verizon software, and even the HP Wireless utilities. This will indirectly shave down your startup taskbar. Don’t forget M$ Works and Office Demo. You don’t need them. Junk Acrobat for FoxIt if you can. I skimmed off 3-4gb disk space easily. For a 16gb SSD, that is nearly 25%.
4. Install a good firewall. You will likely be using wifi at airports or coffee houses, so block out those trojans and worms. I use Comodo.
5. At this point, you should have a usable, speedy netbook. If you’re a perfectionist, you can refer to the standard WinXP optimization guides on the web (including Bootvis).
6. Don’t forget to install some standard programs, like Firefox.
7. Some guides recommend adding another 1gb of memory. While it may help, the standard 1gb ought to be adequate for basic needs. Moreover, a stick of 2gb DDR2 will typically increase heat production significantly. You may not want that unless you’re a big multitasker.

That’s it! Got more suggestions? Post it below! Having spent several hours on this, I am reminded that this is the aspect of usability that Apple simply blows away its competition in.

computing tech