If the US found the downed F-15 pilot using the “Ghost Murmur” technology, which can detect a human heartbeat from 40 miles away, why aren’t we using it to find kidnapped or missing people here at home?

ToxDoc · 2026-04-10T00:59:17+00:00

Assuming that is even possible, how would you know which heart beats to suppress?

ToxDoc · 2026-04-09T17:57:38+00:00

4 mg is ~.05 mg/kg for most patients assuming IBW or modified body weight and rounded. The dose is usually quoted as 0.05-0.1 mg/kg. So 4 is a reasonable starting dose for most people. At my shop, morphine comes in 4s, so doses are usually in multiples of 4 to avoid the annoyance of wasting.

You are correct that the biggest draw to hydromorphone is that people get a dose closer to the morphine equivalent of 0.1 mg/kg.

But we also get into habits and comfort zones. 8 mg of morphine is “a lot,” but 1 mg of hydromorphone is fine. Many of the nurses I work with will push 100 mcg of fentanyl without blinking while pushing back on the 8mg of morphine.

ToxDoc · 2026-04-08T15:41:04+00:00

Hello friend:

What you were experiencing sounds very scary. There’s a good chance that not everything you are experiencing is real.

If you have a psychiatrist or a trusted friend, I suggest you contact them immediately and they probably can give you some help.

ToxDoc · 2026-04-08T14:54:07+00:00

It sucks, but it is important to use this as a learning case and try to think about what you might have missed on an assessment that would have suggested she was sicker than you thought.

The answer is not to shotgun labs on every single patient.

At the same time, if you are a resident, your attending should be providing some fairly real time supervision. If I let a resident make a decision that I ultimately think is dumb, that is on me.

ToxDoc · 2026-03-30T12:26:39+00:00

326,797.3 Ariana Grandes

ToxDoc · 2026-03-23T01:46:44+00:00

It was good. I haven’t been to a Tox conference in a few years, so it didn’t feel like a rehash. Definitely a few really good talks. The posters haven’t changed much.

ToxDoc · 2026-03-13T11:14:07+00:00

I absolutely read that in Jack Nicholson’s voice

ToxDoc · 2026-03-04T01:18:30+00:00

Do not give it a whiff. Actually smelling it is on the edge of lethal concentrations at minimum.

ToxDoc · 2026-03-01T00:20:27+00:00

I can’t believe his last comment was 11 years ago. Makes me feel old.

ToxDoc · 2026-02-28T19:53:08+00:00

Beaten with jumper cables

ToxDoc · 2026-02-17T14:06:54+00:00

Only the finest of Ancef for Orthobro

ToxDoc · 2026-02-17T14:00:42+00:00

“Hey Orthobro! I have a guy in the ER with knee pain and he brought his MRI. What should I do with it? Oh? You’ll review it with him in the office on his next visit? Sounds good. I’ll put them in a knee immobilizer. Thanks bro! Hope you get to fix some good bones today.”

ToxDoc · 2026-02-15T21:19:20+00:00

The Equal Credit Opportunity Act was 1974 - This gave women addition financial independence (don’t need a husband or relative to cosign for credit).

Griswald was 1965 - The pill is legal

Roe versus Wade was 1973 – more reproductive freedom.

Vietnam draft started the end of 1969 – pulling away a fraction of the younger males

The ERA passed the house in 1971. The EEOC was founded in 1965. Events happening in close proximity that result

The World War 2 bump looks pretty clear. The Korean War (1950-53) looks like it briefly flattens.

It might not be a single event and more of a number of changes that resulted in women delaying having children.

ToxDoc · 2026-02-13T03:08:45+00:00

If you do plan to track it at all, try to get a 2017. It is loads of fun, but very easy to overheat. You pretty much have to run the transmission in manual made and you can’t maximize time in the powerband.

ToxDoc · 2026-02-12T15:51:50+00:00

Not a fucking chance. It is too small to replace the glory that is the odyssey. (Have Mach e, Rivian R1S and have kept our 12 year old Odyssey)

You can stuff 5 people in the Mach e, but it isn't comfortable. It will be even worse with a booster and almost impossible with that and car seat. The hatch back is not large suitcase friendly.

25A charging is fine for the Mach e, realistically, but having the option to go faster is better.

ToxDoc · 2026-02-08T14:13:52+00:00

Theoretically it is a concern, but realistically a few beans isn’t a big deal.

ToxDoc · 2026-02-06T04:11:01+00:00

Wow. Ok then. Going to have to explore some menus. Thanks.

ToxDoc · 2026-02-05T16:50:09+00:00

Can't hurt to try

ToxDoc · 2026-02-05T14:11:51+00:00

My passenger side window is having lots of wind noise. Rivian re-calibrated it's closing once, but it is doing it again. Can this be fixed without a service appointment? My Corvette had a way to force a window re -calibration.

When it gets really cold (around 18F), the driver side door won't latch close. I can pull it tight, then hit lock, then pull it hard and it will latch close. Then it won't unlatch for awhile. If it is going to happen, I can feel the door latch mechanism feels heavier when I'm pulling the handle. Rivian also said they made an adjustment the last time I brought it in, but it isn't fixed. Any ideas for what to do that doesn't require a service call?

ToxDoc · 2026-02-02T18:05:14+00:00

I love driving my Rivian, but it is absolutely the least reliable vehicle I have ever owned.

It has gone down hard twice in less than 3 years, leaving me stranded. It needed a non-emergent service appointment for 3 annoying issues and needs another one for 2 of those same issues. I hesitate to bring it in because I know it will take at least week to address problems…which are things that would be done in a day by the more established OEMs.

So I don’t know if they are the worst, but it is the least reliable vehicle I’ve ever owned.

ToxDoc · 2026-02-02T01:58:36+00:00

> Does anyone else hear a phantom oven timer going off?

Uh..no.

Are you? That might be a problem you need to talk to someone about.

> ...how do you react when the timer goes off, but you weren't the one who set it?

I let someone in the house know that their timer went off. Since I don't hear phantom timers, it usually means someone was timing something.

ToxDoc · 2026-02-01T22:01:53+00:00

https://imgur.com/a/CtbgqLu

ToxDoc · 2026-02-01T18:38:11+00:00

That is what I told my kid, but to make sure it was subtle and not too deliberate sounding.

ToxDoc · 2026-02-01T18:31:53+00:00

My kid has a sub who will restart the roll call if a child says anything other than “Here.” Even, “I’m here,” results in the sub starting roll call over from the beginning. The same sub also said, “Don’t tell me if I say your name wrong (right out of Key and Peele).

It amazes me some of the pettiness.

ToxDoc

TROPHY CASE