VOLTAGE, OR—In what can only be described as “shocking” news, the FDA recently approved a novel implantable cardioverter-defibrillator that not only senses dangerous arrhythmias but also doubles as a Covid-19-prevention device. Indeed, this new AICD has been specially programmed to deliver shocks to the heart every time a user touches his face.

“Humans touch their faces constantly, and that’s one way for harmful germs, like the coronavirus, to get into our eyes, noses, and mouths. I’ve been telling people they must stop doing this for months, but no one listens,” said Dr. Anthony Fauci disapprovingly, as he rubbed his eyes and picked his nose.

Doctors believe the best way to change this hazardous behavior is by sending 300 Joules of electricity to the heart each time people touch their faces. “I believe it’s called aversive conditioning, or maybe negative reenforcement,” said an exhausted Fauci. “Ah, who the hell knows what it’s called? Basically, we zap your hearts, you feel like you’ve been kicked in the chest, and you quickly learn to stop touching your damn face.”

Early users of the new technology claim it works very well. “The first day I was shocked three dozen times, and one week later, I never touch my face,” said Alec Tristy, who lamented that despite that, he’s now getting shocked way more than ever before. “Whenever I piss off my wife, which is always, she gets back at me by touching my face! Even my kids are doing it now—‘Let’s shock daddy!’ they excitedly say.”

Speaking of young kids, they are known to be among the most guilty of excessive face-touching. Starting this fall, all day-care centers and preschools will mandate that kids have these AICDs implanted. “Can we also program their devices to shock them every time they don’t listen to us?” pleaded one teacher.

Another early user, Ms. Jules Anne Watts, complains that the sensor is way too sensitive. “It shocks me anytime anything touches my face. Water in the shower—ZAP! Putting on makeup—THUMP! Putting my head on a pillow at night—JOLT! I have to sleep standing up now!”

At press time, Mr. Tristy was in the midst of an epic battle with a pesky itch on the tip of his nose. He was determined to overcome it as he did not want to get—ZAP! “Oh well, it was totally worth it,” he said, as he recovered from the painful shock. “Itches can be so excruciating!”

ALLAS, TX—A major principle of medical ethics is that of autonomy, which states that patients should be highly involved in decisions regarding their health care. In an effort to better comply with this essential principle, the American Heart Association (AHA) has recently recommended that, whenever possible, patients should “run their own codes.”

In the past, ethicists believed that simply allowing patients to choose whether they wished to be resuscitated or not (DNR vs Full Code) was enough to satisfy the principle of autonomy. “It’s now crystal clear,” said medical ethicist, Ed Thickle, “that this does not go far enough. The old paternalistic model of doctors shouting out orders for epinephrine, shocks, and more without involving the patient is simply unacceptable today. When someone chooses to be Full Code, that patient, when in cardiac arrest, should be able to fully guide how the code is run.”

In fact, if the code discussion had never yet taken place, the doctor is encouraged to halt CPR to review with the patient the various therapeutic options available in a crash cart. “Cardiac arrest is as good a time as any to have this discussion,” said AHA spokesperson A.C. Ellis, “because otherwise, how would the patient know what medications to order?”

Early results of patient-run codes have been mixed. “Most of the time, we just stand around waiting for guidance, but it never comes,” said ICU nurse, Rhee Sustate. “While leading the code, these patients tend to be silent and frozen in place, and on occasion, they even wet themselves…so, in other words, they’re no different than interns running codes.”

Others complained that these patients have unrealistic expectations about resuscitation attempts even when they are proving futile. “I wish this guy would pronounce himself dead already,” said a nurse named Maya Armertz as she entered her 48th consecutive hour of compressing his chest.

Meanwhile, some patients sought to take advantage of their new power. Nurse Sustate recalled a patient named Connor Tist who called a code on himself, claiming to be in ventricular fibrillation. “I was initially skeptical because, to me, it looked like he was in normal sinus rhythm, and he was awake, alert, and talking. Then, instead of CPR and shocks, he ordered repeated injections of Dilaudid. I’d never heard of opioids having resuscitative effects, but who was I to argue with the person running the code?”

When confronted about it, Mr. Tist snapped, “Um, my VFib really hurts, okay?!”

Overall though, medical ethicists are thrilled that patients are finally having more say during their most vulnerable time. The AHA, meanwhile, has this piece of advice for interns and residents: “Next time a code is called, there’s no need to sprint to the room. The patient’s got you covered.

Toronto, ON – In a world first, Dr. Chipper has carried out what we’re cautiously calling a successful open reduction and internal fixation (ORIF) of the aorta.

The patient, 58-year-old Joe Paulson was booked for an elective hip replacement on December 21, 2019. As Dr. Chipper was reviewing Joe’s films, he spotted a strikingly displaced and angulated bone; later identified as a severely calcified aorta, on Joe’s pre-op chest films. Concluding that anatomical function would be severely limited in this awkward position, Dr. Chipper snuck in a quick aortic ORIF while the anesthesiologist was fiddling with IV tubing. Three plates and thirteen screws were used to secure the freshly osteotomied aortic arch. Two K-wires brought the distally communited bone fragments, now known to be aortic valve leaflets, into ?anatomic¿ position.

We are happy to report that Joe is doing well other than a moderate headache and a whooshing sound in his ears. In a tip picked up from rheumatology, Dr. Chipper is managing Joe’s somewhat cool lower extremities with a topical nitroglycerin ointment.

We are unable to explain how Joe is possibly alive. Mere days after learning about the outcome of this case, the anesthesiologist involved was admitted to a psychiatric ward after colleagues found him rambling about ‘physiologic sense’ and drawing elaborate flow diagrams in the hospital basement. This anesthesiologist is not alone in his struggles.

The radiologist who read the post-op films tells us she was so confused that she actually left the department to clinically correlate herself. The cardiology department has collectively refused to follow Joe citing a lack of studies looking at the effect of antiplatelet medications on screws.

On the other hand, the hospital’s prestigious vascular surgery program has repeatedly attempted to recruit Dr. Chipper in hopes of studying his elusive surgical techniques. Several emergency physicians have already attempted to refer aortic aneurysms and dissections to Dr. Chipper’s fracture clinic. When asked to comment on the case, Dr. Chipper had this to say: “bone straight”.

Pyongyang, North Korea – Reports have been coming out that North Korean Supreme Leader Kim Jong-un’s health is in grave danger after a cardiac procedure. Allegedly, the anus-free Dictator allegedly had a cardiac procedure last week likely related to his BMI of 47 being higher than his presumed age of 37, the dreaded “Rosie O’Donnell” sign.

There are rumors that Kim John-un may in fact already be brain-dead, something many in the west have believed for years.

Since taking over after his father, Kim Jong-Il’s death in 2011, Kim Jong-un has led the reclusive socialist nation to being one of the poorest countries in the world. Presumably because he eats 75% of the nation’s GDP annually.

North Korean state-run media announced today that “Dear Leader is just fine, nothing to see here. We are just letting his lungs, heart, and brain rest for a little while.”

Dr. Byung Kim, the dictator’s cardiologist was not made available for interviews. State-run media reported “The doctor said Kim Jong-un’s heart is the strongest in the world, better than best American athletes. Dr. Kim has graciously offered his heart to Dear Leader should Dear Leader’s heart ever fail. We plan on taking him up on that offer.”

If anything negative happens to Kim Jong-un, it is very likely that Dr. Kim may join North Korea’s first and only COVID case and have the opportunity to die for his country. The ability to die for their country is one of the many reasons the rest of the world has been so peanut butter and jealous of North Koreans.

In a move that has rocked the healthcare industry, cutting edge health system Donta Care has enlisted the help of clowns in their emergency rooms and cardiac catheterization units to reduce door to balloon times.

“As the saying goes,” CEO Em Aye proudly announced in his press conference, “time is muscle. We were really struggling to meet our cardiac quality metrics. But I was at my niece’s 8-year-old birthday party, and Fluffy the Clown was creating all sorts of marvelous balloon animals- and not just the usual sword and dog. I’m talking planes, flowers, and butterflies. Suddenly I had an epiphany: Why are we spending millions of dollars keeping a cath team and a procedure suite ready to go at a minute’s notice, when Fluffy, and his side kick Jabba the Hound, will stay on site for $20 an hour? Did I mention that magic tricks and a juggling show are also included?”

In addition to surpassing every interventional cardiac quality measure, this move has sent their competitors scrambling because patient satisfaction scores have also skyrocketed since the change was made.

“I couldn’t be more pleased,” said patient Cad Aver, “I came in nauseous, sweaty and with this squeezing feeling in my heart. I got a balloon replica of the Eifel Tower, and he even made a few more for my grandkids who were with me! I still feel like there’s an elephant on my chest- but at least now I have a pink balloon elephant to go with it! I’m leaving a new man and my family is relieved that it was nothing serious.”

This innovation appears to be the gift that keeps on giving: Donta Care has also seen record drops in their hospital readmission rates. “We’re not sure what to make of it, we suspect that patients are just leaving so happy and properly diagnosed that they just don’t need to come back.”

According to a recent press-release, of the 577 high-risk chest pain patients that have been to their emergency room in the past month, only 1 has ever returned within 30 days, and that only because his grandchildren wanted different color balloons. We attempted to verify this by reaching out to the multiple patients who did not return, but unfortunately all the ones we tried to call had passed away of apparent unrelated issues.

ST. PAUL, MN – In response to patient feedback on how to make their medical devices even better, Shmedtronic is slated to release a new combined implantable cardioverter-defibrillator (ICD), permanent pacemaker (PPM), and WiFi hotspot in February.

Shmedtronic told Gomerblog that the new device was specifically designed based on feedback from over several thousand patient surveys, where the number one most requested improvement was having wireless networking capabilities.

“The older ICD-PPM model probably saved my life on a couple of occasions,” wrote one anonymous patient in one of the Shmedtronic surveys. “But when I’m feeling well and not dealing with any issues related to my heart, I have to use data on my phone plan, which is a complete downer. Isn’t there any way we can fix that?”

Another patient echoes the same theme in another survey: “This device has shocked me out of dangerous rhythms several times, but while I waited for EMS I couldn’t surf the web since I was in a 4G and WiFi dead zone. What gives, Shmedtronic?”

According to interventional cardiologists, placing an ICD/PPM/WiFi device is similar to implanting previous Shmedtronic devices. The only difference is to confirm functionality they check both Facebook and last night’s scoreboard.

Study patients who have used the new combined ICD/PPM/WiFi device note significantly fewer episodes of symptomatic tachycardia now that the stress of accessing a good connection has been dramatically reduced. One cardiologist involved in the study is “confident” that most episodes of symptomatic arrhythmias are “due to the stress of finding a good WiFi connection.”

Shmedtronic states the only drawback of the new device, which “isn’t too big of a deal,” is that if you share password access to your WiFi, then others can change the settings on your pacemaker and defibrillator.

Thank you very much for this very interesting consult for clearance for cardiac catheterization in this lovely man who is unfortunately having a myocardial infarction and needs some contrast dye. Even if his estimated GFR has been reported as > 60 ml/min, who knows what the real GFR is, right? So it was very important to get renal involved.

First of all, I have to say you guys need to come up with a better way to diagnose MIs- come on man its 2019 and you’re still using that “dye” to look at the heart- can’t you use like Co2 or something? Or just guess from the EKG where the stent should go in without actually having to put the whole 3 cc of dye in ?

The whole practice of medicine is changing towards safe practices so this is really not acceptable. Secondly, as I said before, even though the eGFR is reported > 60 ml/min, who knows what it is- it maybe 61 or 120- so do you really want to take the risk of dropping someone’s GFR from 61> 50 and tell them they now have CKD and have a higher risk of ending up on dialysis compared to general population? Think about it, whats the point of saving their life now if they will be on dialysis in 15 years from now?

So, my strong recommendation for this patient is NOT to get any dye. He is NOT cleared for cardiac cath and if you ask me this question 5 more times during the course of his stay, I’m going to say NO. Its against my work ethics, against the whole practice of nephrology and most importantly, against safe patient care. So please don’t call me again.

Yours truly
Renal Fellow.

Washington (DC). Research published today revealed that many of our politicians may be essentially dead, or close to dead. The study used data mining to evaluate heart rate profile of Washington senators and representatives while Congress was in session. Data were obtained via Apple Watch and similar devices.

“Many of members did not have a heart beat at all,” said Dr. Geetha Flak, who led the study. The result came to a surprise to the investigators. “We had suspected that many members of Congress are emotionally underdeveloped,” said Dr Flak, “but the fact that they do not have a heartbeat – and presumably many don’t have a heart at all – came as a surprise.”

Furthermore the subjects that did have detectable rhythms often had ventricular tachycardia or fibrillation. The median heart rate was higher in the House of Representatives, maybe because members are younger on average. “It is interesting that we don’t see any reported deaths, especially in the Senate. In our paper we postulate this may indicate a high prevalence of zombies, or maybe fossils, but that remains speculative,” said Dr Flak. “It should however be noted the near absence of sensible legislation making it out of the chambers supports this hypothesis.”

What peaked interest was a clear dichotomy in the heart rate profiles. While data was anonymized, location within the chamber could be extracted from GPS coordinates. Asystole was more prevalent on the right side of the aisle, where as Vtach/VFib predominated on the left. There was also strong correlation with certain legislation. Discussion of abortion or gun control seemed to stimulate the right, many showing an agonal rhythm and some even maintaining frequent escape beats, while at the same time the left almost entirely was in VFib (“LAFB”, Left of Aisle Fibrillation en Bloc). Conversely, health care issues put the entire right chamber into cardiac standstill (Flak dubbed it Right Bench Block).

Next, Flak’s team will tackle a much more ambitious goal, “We are planning a comparative effectiveness study, looking at the US versus other countries’ executive government branches, “ she said. “The study will utilize functional MRI and EEG monitoring. “We are hoping to show non-inferiority of the US, however with the latest developments, I am note sure we have any brain activity in the White House at all.”

SANTA FE, MN – For guests who want to experience the ultimate in relaxation, the spa at the Inn of the Four Extremities is offering a 55-minute carotid sinus massage. It is the first spa in the United States to do so.

“We’re very proud of this new addition to the spa menu,” explained Grace Vargas, one of the spa’s massage therapists. “The results are universal: every single guest reaches levels of relaxation never before reached. In fact, we can barely wake them all up.”

According to the spa’s website, the traditional carotid sinus massage uses arnica oil, herbal packs, deep pressure, and fluid strokes to relax the body by working out all the knots in those “pesky” afferent nerve fibers in the carotid sinus, thereby “delighting” cranial nerve IX and the medulla oblongata. The pressure is provided for a generous 55 minutes.

Unfortunately, this carotid sinus massage is contraindicated in guests with recent strokes, transient ischemic attacks, and heart attacks, or a history of ventricular arrhythmias.

Of note, guests are able to enhance their carotid sinus massage with optional additions of a steam, scrub, Himalayan sea salts, or Ayurvedic telemetry.

NASHVILLE, TN – A patient has undergone successful prophylactic cardiac resection at Nashville Medical Center today in a “very proactive effort” to mitigate any future chance of developing cardiovascular disease, Gomerblog reports. 

Cardiac resection is rarely performed in living patients due to its main complications death and fatality.

“The patient weighed the pros and cons of keeping his heart versus having it removed, it was an informed procedure for sure,” said cardiothoracic surgeon Donna Howser, who performed the operation earlier today.  “I think he surprised us all with how well he is doing post-operatively.”

Based on the operative note, Howser quickly gained access to the mediastinum, where she quickly and swiftly resected the heart.  Howser opted against anastomosing any of the great vessels, essentially leaving the chest cavity and wound to heal entirely by secondary intention.

Of note, the patient is 28 years of age, without any family history of heart disease or risk factors for cardiovascular disease.

“I mean, they just extubated him in the ICU, his vital signs amazingly look pretty great, and his hemoglobin is holding stable,” Howser told Gomerblog.  “This could be the future of cardiac prevention. He is the very first case; obviously, we’ll need to do a few more of these surgeries and trend it out. Plus, we’ll all have to get used to the silence on heart exam.”

If the patient continues to do well, patient will consider undergoing prophylactic resection of all organ systems later this year.