White Feathers

Inspired to write a poem on peace, seeing as the 21st of Sept was/is the International Day of Peace.

a white feather fell from heaven

doves fly by

a bullet whistles past

blood drips from the bough of a tree

peace in our time is the mantra

can it be believed



cowardice, faith, protection, bravery

peace

so many messages, to which do we cleave

hope from beyond; past, present or future

don’t shoot the messenger



crying white doves circle

hoping they do not die bringing their message

doves cry where children die

hope dies when doves cannot fly

may they be lifted on the wings of peace

upwards to a burning sky

to a place with no name



the sun sets on a world in disarray

how many more white feathers need to fall from a burning sky

the spirits are watching

are they at peace?

I pray that they will be

 

© 2016 Michael D Emmerich

Fuck War!

draft or dodge

conscription or jail

exile or war

hero traitor or coward

choices that define or break


who is the enemy


the just or unjust war

justified by the church

who stands aside

letting death slip quietly by

welcoming death

in gods name it shall be done


who chose this war


justified by the politician

arrogance greed and power

forcing boys to become men

to become killers

for the sake of an ‘ism, as told by an idiot


who has the most to lose


who binds the wounds that bleed

the scars that don’t heal

the wounds you cannot see

none but the fellow beside him

neither the church or politicians

in whose name their blood is discarded

along with their futures
 

whose life is to be sacrificed


not mine said the politician, suckling on the teat of corporate greed

not mine said the bishop, god made me do it

not mine said the arms dealer, I just sell death

not mine said the general, I’ve done my time

not mine said the wealthy, the poor are the pawns

not mine said the socialite, I’ll read it on page seven


who has the most to gain


At whose cost

At what cost

WHY?

FUCK WAR!

 

© 2016 Michael D Emmerich

Trust ?

Trust none of what you hear, and less of what you see

Bruce Springsteen – Magic, 2007

trust openness honesty

who to trust

what to trust

deception deceit

seen through a veil

now hidden

obscured

mists

clouds

no rainbows

no pots of gold

hollow men

hollow words

blind men

blind followers

fire below

fire above

eyes wired shut

ears grown closed

mouths wide open

no sound

no trust

just white noise

 

© 2016 Michael D Emmerich

Juxtaposition Junxtion

to be or not….

the journey along the road

leads us to be often waylaid

arriving at at juxtaposition junxtion

confused over our mother being our lover

lost in the paradise of milton’s world

unsure if it be heaven or hell

one mans heaven being the others hell



to have or to have not

said the butler living in squalor

but trapped in luxury

disparity and discord morph into a third way

can it all be fair in love and war

sound and fury, calm before the storm



before and after, fat and thin

can all pigs be equal

fighting to live

battling to not die

food to one is death to another

in darkness there is light



what the dickens is going on

wisdom and foolishness battling for hope

it springs eternal in the winter of our discontent

everything to lose and nothing to win

goodness draws forth evil

the circle draws to a close



the bells toils

before the wall is rent asunder

the third way beckons

like a long lost lover

 

© 2016 Michael D Emmerich

The Forgotten Soldier

history written by the victorious

remembered by the soldier

forgotten by all

battered, bruised, discarded

honour cast aside

no medals for the forgotten warrior



once forgotten

memories now return

new wounds emerge

new scars

new pain and guilt

but still society forgets



wars once popular

now become an anathema

silence abounds

but the memories remain



history written in black

but remembered in blood

history written in scars

survives beyond the fading text



politicians write the history

soldiers carry the weight of that history
© 2016 michael d emmerich
© 2016 mikesnexus.com

New Medical Writings

Feeling very proud; I have been approached by a Canadian based medical site to submit articles for publication. They are a Pan-Access worldwide collective of experts and non-experts creating a discussion about infection control and prevention using their  online publication forum, http://www.InfectionControl.tips

Check out my profile and my first article cleared for publication (working on the next few)

http://infectioncontrol.tips/author/memmerich/

Managing Infection Control in a Disaster

We Were all Once Aliens

we don’t live her anymore

we have since moved on

the vacant and to let signs are posted

we have no forwarding address

we have moved on to another place to call home



we are following in the footsteps of our ancestors

and yours!

they were welcomed with open arms

we welcomed them with open arms

why do we find the doors closed

and signs saying move along

nothing to see or do here



no place for the refugee, the immigrant

no place for those who look different

no place for a fellow human being

our home becomes the street

the tented shelter



we don’t live anywhere anymore

we have no where to call home

so alone

 

© 2016 Michael D Emmerich

The Arrogance of Entitlement

have we moved from the age of aquarius

to the age of narcissus

has the arrogance of entitlement

led us down the garden path

of hopelessness

the era of violence by web post

faceless nameless aggression

all in the pursuit of their ideology



 the entitled with their economic superiority

need to learn to bite their tongue

in the presence of those with smaller bank balances

lording ones perceived elevated status

at best lowers your intellectual status

at worst it negates your work

and the work of those with less arrogance



 why should a healthy bank balance

come with a condescending attitude

economic might does equate to being right

arrogance brings a sense of entitlement

in the person

more than actual entitlement



 we are left with the audacity of hope

in the presence of arrogance

entitlement should not usurp our history

let peace be our guide

as we chart our way through the islands of arrogance

 

© 2016 Michael D Emmerich

The Banality of Corporate Deceit

values, ethics, morals are left in tatters

conveniently sacrificed on the alter of economic greed

moral responsibility is abdicated in fiscal matters

bruised and cast aside for their misdeeds



it's not me, just following orders

it's not my department

I was just the warder

its all in separate compartments



careers built on careerism and obedience

orders coming from persons above

no regard for others, expedience

non ideological, and no thought of the actions thereof



as good as saying the devil made me do it

its gods will

the cry of the uncaring hypocrite

is enough to give the victim a chill



as the the chorus beats its drum

and the new song cuts to the core

the new mantra now oft chanted has become

oh for a few dollars more

 

© 2016 michael d emmerich
© 2019 michael d emmerich
© 2019 mikesnexus

TECHNOLOGY IN MEDICINE

TECHNOLOGY IN MEDICINE

Past, Present and a Possible Future – Help or Hinder

Published in Sanguine, journal of the ECSSA June 2015

Technology in Medicine, a topic many in EMS chat about, and if we have been in service for 20 years plus, we have then been privileged (or cursed) to see significant changes across the board with regard to equipment, patient care, protocols and drug therapies. Many of us have actively pushed for change and new equipment; be it with regard to fluid therapy, bleeding control, pain management and airway management. As one who has been active in certain areas pushing for change, we sometimes miss the most crucial approach to patient care; neatly summed up by Hippocrates (400-ish BC)

Cure Sometimes. Treat Often. Comfort Always

The classic approach to patient care has always been underpinned by the following:

  • Arrive at a diagnosis by patient consultation and physical hands on examination

  • Confirm ones diagnosis via various diagnostic devices

  • Reaffirm ones diagnosis by means of special investigations

Will technology change this approach for better or the worse?

If we look back at history, we see that not all new technologies have been readily accepted by the medical community. Many were viewed (are viewed) with suspicion. In the 1930’s some doctors doubted an X-ray image of the chest was as reliable as a physical examination. Devices threatened to replace the diagnostic expertise of the traditional doctor. Many doctors have valued their clinical experience over machine-produced information. Other technologies initially failed because doctors or patients found them impractical. The ECG was only useful when it became portable and reliable enough to be used at the patient’s bedside.

We need to also seriously review our progress in Medical Technology with regard to changes that offer only incremental benefits but at much higher patient care cost. The focus must be on evidence-based product development, manufacturers have to be able to show their products and new technologies will add value to their customers. Does new technology automatically translate into better patient care and most importantly improved patient outcomes.Plus we need to ask the question; who is their customer, the patient or the medical practitioner? If we as practitioners treat our patients as customers, they will act like customers, we need to be very careful of venturing into a quagmire such as this.

The entire patient/medical practitioner relationship is also changing, as the patient has access to a wider range of medical information, our patients are possibly smarter (maybe). Patients have access to more medical information, with the end result, that at times, they might be less trusting and prone to ask more questions of their medical practitioner. As practitioners we must be open to this new questioning patient and be willing to answer more questions than we did in the past.

Taking cognisance of all of the above: what is the health care practitioner to do?

There is an acknowledged gap in the “bench to bedside” cycle of medical discovery and its implementation in clinical practice, which can mean a gap of years changing “what we know to what we practice”.Hence the treatment of patients in an emergency setting should not only be concentrated on developing new technologies, but must also involve proper training and skills development; medical talents needs to be honed. New technologies MUST always mandate new skill sets, protocols and procedures.

An area of import in my opinion in medical development is patient information. The more information we have on the patient at hand, will allow us to render more appropriate patient care. Information and knowledge management is critical in helping with the decision making process and thereby improving patient care. Many medical practitioners believe that patients should take an active role in managing their own health information, because it fosters personal responsibility and ownership and enables both the patient and practitioner to track progress outside scheduled appointments and at times of a medical emergency. Patient smart cards is one way to grapple with this issue of information. It will allow patients to upload their health records via a flash drive and carry their information with them in their wallet. Information may be accessed through cloud-based storage and encrypted systems anywhere in the world, or plugged into medical smart readers. Medical practitioners can update to cloud technology in real time and the patients own medical doctor can be alerted to changes in the cloud files.

Another key area where technology can aid us in having more information at our fingertips is via a “differential” diagnosis or problem list, which is accessed via the cloud and links to our patient file and further information we input. After we have reviewed the patient “history” and examination. (e.g. is this appendicitis? a urinary tract infection? constipation? inflammatory bowel disease?) The practitioner must then troll his memory banks and innate knowledge base, or one may need to consult texts/online sources to check up/confirm their thinking. Cloud based technology could aid us and speed up the confirmatory differential diagnosis. As their is no doubt much room for improvement in the current approach, with many practitioners currently relying on their tacit knowledge base at the frontline which, while mostly effective, is subject to human error. Once the differential diagnosis or problem list is drawn up, then a related treatment plan could be formulated, and treatments in the form of procedures and/or prescriptions for medications may be suggested by our cloud database.

Emergency Medicine must continue its current academic trajectory, to keep pace with the challenges that technology brings to our patient care. If academic training lags behind the technology curve our practitioners and therefore our patients will be the poorer. We must ensure that there is now technology/practitioner gap as we continue to push the boundaries in improving our patient care. The danger of technology, is that it has the ability to make us lazy and self reliant. It has become noticeable in certain areas of emergency medicine how our reliance on technology has allowed us to forget the three cornerstones of good medicine, diagnosis, confirmation and reaffirmation; of which the diagnosis and confirmation are reliant on us having a hands on approach to our patients (which is becoming a dying art). Good solid diagnostic skills will always be an essential tool of medicine, especially emergency medicine, we forget this at our and our patients peril.