Knock Knock, Hi! with the Glaucomfleckens

This week, Kristin and I talk with Jason Pang, Director of EMS, and Joe Stoffolano, Division Chief of Community Risk Reduction in Miami Township, Ohio. These guys take us deep into the world of pre-hospital medicine. We’re talking how EMS is funded, why those funding streams vanish, the future of EMS, and much more. We also break down how 911 dispatch actually works, how EMS decides what units to send, why response times vary so wildly across the country, and why dispatchers are the unsung heroes of every medical emergency. If you’ve ever wondered what really happens before a patient hits the hospital doors, or why EMS systems are constantly fighting to stay funded, this is the episode. Takeaways: Why property taxes are the backbone of EMS and what scary legislation could wipe out funding overnight. How pre-hospital blood transfusions actually work, who gets them, and why they’re becoming a game-changer. What a lateral canthotomy in a helicopter looks like, and why an 11-blade scalpel is not invited. The emotional weight of dispatchers, and why they’re the only person with you during the worst 10 minutes of your life. Why EMS is “an ER on wheels”, and how they juggle advanced medicine, unpredictable environments, and community expectations. — To Get Tickets to Wife & Death: You can visit Glaucomflecken.com/live  We want to hear YOUR stories (and medical puns)! Shoot us an email and say hi! [email protected] Can’t get enough of us? Shucks. You can support the show on Patreon for early episode access, exclusive bonus shows, livestream hangouts, and much more! –⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ http://www.patreon.com/glaucomflecken⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠  Also, be sure to check out the newsletter: https://glaucomflecken.com/glauc-to-me/ If you are interested in buying a book from one of our guests, check them all out here: https://www.amazon.com/shop/dr.glaucomflecken If you want more information on models I use: Anatomy Warehouse provides for the best, crafting custom anatomical products, medical simulation kits and presentation models that create a lasting educational impact.  For more information go to Anatomy Warehouse DOT com. Link: https://anatomywarehouse.com/?aff=14 Plus for 15% off use code: Glaucomflecken15 -- A friendly reminder from the G’s and Tarsus: If you want to learn more about Demodex Blepharitis, making an appointment with your eye doctor for an eyelid exam can help you know for sure. Visit ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠http://www.EyelidCheck.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ for more information. Produced by⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Human Content⁠⁠⁠ Learn more about your ad choices. Visit megaphone.fm/adchoices

Hollywood, we need to talk. If one more movie shows an eyeball dangling from someone’s cheek, I might start mailing anatomy textbooks to Los Angeles. And while we’re at it, can we please stop calling every wandering eye a “lazy eye”? After a quick rant about my personal ophthalmology pet peeves, I dive into one of the strangest mystery cases I’ve ever seen: a 47-year-old with sudden, complete ophthalmoplegia and normal imaging. Negative myasthenia testing, normal pupils, normal MRI, nothing made sense until one very specific antibody came back positive. Takeaways: Why “lazy eye” rarely means what people think it means and what the term actually refers to. The Hollywood eyeball trope that needs to be banned forever (optical nerves are short, folks). How a patient with zero eye movement and a normal MRI sent us searching for rare neuro clues. Why myasthenia gravis seemed like the obvious answer until every serology test came back negative. The surprising role a GI infection can play in triggering Miller Fisher syndrome, the rare Guillain-Barré variant that ultimately cracked the case. To Get Tickets to Wife & Death: You can visit Glaucomflecken.com/live  We want to hear YOUR stories (and medical puns)! Shoot us an email and say hi! [email protected] Can’t get enough of us? Shucks. You can support the show on Patreon for early episode access, exclusive bonus shows, livestream hangouts, and much more! –⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ http://www.patreon.com/glaucomflecken⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠  Also, be sure to check out the newsletter: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://glaucomflecken.com/glauc-to-me/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ If you are interested in buying a book from one of our guests, check them all out here: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.amazon.com/shop/dr.glaucomflecken⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ If you want more information on models I use: Anatomy Warehouse provides for the best, crafting custom anatomical products, medical simulation kits and presentation models that create a lasting educational impact.  For more information go to Anatomy Warehouse DOT com. Link: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://anatomywarehouse.com/?aff=14⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Plus for 15% off use code: Glaucomflecken15 -- A friendly reminder from the G’s and Tarsus: If you want to learn more about Demodex Blepharitis, making an appointment with your eye doctor for an eyelid exam can help you know for sure. Visit ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠http://www.EyelidCheck.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ for more information.  Today’s episode is brought to you by Microsoft Dragon Copilot. Dragon Copilot is an AI clinical assistant that streamlines documentation, surfaces critical information, and automates routine tasks — empowering healthcare teams to focus more on patients and less on administrative work. Learn more at ⁠⁠⁠⁠https://glau.cc/Dragon⁠⁠⁠⁠ Go to http//www.cozyearth.com and use code KNOCKKNOCK for 40% off best-selling temperature-regulating sheets, apparel, and more. Trust me—you’ll feel the difference the very first night. Produced by⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Human Content⁠ Learn more about your ad choices. Visit megaphone.fm/adchoices

This week, Kristin and I answer listener comments about colonoscopy prep, including a truly cursed diet of mashed white vegetables and learn about Cologuard, the screening test where you… mail your poop. Through the actual mail. To a stranger. We also dive into the ongoing household war known as “Kristin Won’t Stop Sleeping in Her Contacts,” which leads to a horrifying discussion about wrinkly eyeballs, saggy conjunctiva, and what happens when an eyelash embeds itself in your eyelid gland and starts scraping your cornea. Delightful. Then we get to my new favorite segment: diagnosing cartoon characters. This week we tackle Goofy, who very clearly has a mild form of cyclopia, and debate whether his son Max avoided the gene… or if Goofy needs to have some questions answered at home. We even break down why large eyeballs mean myopia, why Edna Mode is basically a hyperopic queen, and the extremely nerdy world of axial length. Finally, we open the First Aid book and Kristen learns what an Apgar score actually measures and no, it’s not “how cute the baby is,” and no, the Babinski is not part of it either. It’s New Year’s nostalgia, poop-mailing, cartoon diseases, eye crimes, and newborn scoring systems, basically, a classic Knock Knock Hi episode. Takeaways: The Great New Year’s Trick: How to convince your small children midnight arrives at 9 PM. Colonoscopy Diet Horror: Boiled pale root vegetables, no grains, no legumes, no joy. Eye Crimes: Saggy conjunctiva, wrinkly eyeballs, embedded eyelashes, and the marital tension of sleeping in contacts. Goofy Has Cyclopia: A shockingly thorough medical analysis of cartoon genetics (plus: what’s up with Max?). Apgar Breakdown: The real meaning of appearance, pulse, grimace, activity, and respiration and why Kristen’s “toe swipe” theory was… not Apgar. — To Get Tickets to Wife & Death: You can visit Glaucomflecken.com/live  We want to hear YOUR stories (and medical puns)! Shoot us an email and say hi! [email protected] Can’t get enough of us? Shucks. You can support the show on Patreon for early episode access, exclusive bonus shows, livestream hangouts, and much more! –⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ http://www.patreon.com/glaucomflecken⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠  Also, be sure to check out the newsletter: https://glaucomflecken.com/glauc-to-me/ If you are interested in buying a book from one of our guests, check them all out here: https://www.amazon.com/shop/dr.glaucomflecken If you want more information on models I use: Anatomy Warehouse provides for the best, crafting custom anatomical products, medical simulation kits and presentation models that create a lasting educational impact.  For more information go to Anatomy Warehouse DOT com. Link: https://anatomywarehouse.com/?aff=14 Plus for 15% off use code: Glaucomflecken15 -- A friendly reminder from the G’s and Tarsus: If you want to learn more about Demodex Blepharitis, making an appointment with your eye doctor for an eyelid exam can help you know for sure. Visit ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠http://www.EyelidCheck.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ for more information.  Today’s episode is brought to you by Microsoft Dragon Copilot. Dragon Copilot is an AI clinical assistant that streamlines documentation, surfaces critical information, and automates routine tasks — empowering healthcare teams to focus more on patients and less on administrative work. Learn more at ⁠⁠⁠https://glau.cc/Dragon⁠⁠⁠ Produced by⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Human Content⁠⁠⁠ Learn more about your ad choices. Visit megaphone.fm/adchoices

This week, I start by sharing why First Descents, the nonprofit that helped me rebuild community and trust in my body after cancer, deserves a spot on your end-of-year giving list. And then, because it is Christmas, I diagnose the eyeballs of Charlie Brown, the Grinch, Rudolph, and even Jack Skellington. From aniridia to jaundice to reindeer esotropia, it’s a holiday episode only an ophthalmologist could make. Takeaways: The nonprofit that helped young adult cancer survivors, including me, find community, courage, and connection. Why Charlie Brown may actually have a real eye disorder (and why that “lovable loser” label is unfair). The Grinch’s alarming scleral icterus and what it says about his liver. Why Rudolph’s esotropia would make guiding a sleigh… mildly concerning. How Jack Skellington manages life with bilateral enucleation and why Sally might actually have the healthiest eyes in Halloween Town. To Get Tickets to Wife & Death: You can visit Glaucomflecken.com/live  We want to hear YOUR stories (and medical puns)! Shoot us an email and say hi! [email protected] Can’t get enough of us? Shucks. You can support the show on Patreon for early episode access, exclusive bonus shows, livestream hangouts, and much more! –⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ http://www.patreon.com/glaucomflecken⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠  Also, be sure to check out the newsletter: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://glaucomflecken.com/glauc-to-me/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ If you are interested in buying a book from one of our guests, check them all out here: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.amazon.com/shop/dr.glaucomflecken⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ If you want more information on models I use: Anatomy Warehouse provides for the best, crafting custom anatomical products, medical simulation kits and presentation models that create a lasting educational impact.  For more information go to Anatomy Warehouse DOT com. Link: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://anatomywarehouse.com/?aff=14⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Plus for 15% off use code: Glaucomflecken15 -- A friendly reminder from the G’s and Tarsus: If you want to learn more about Demodex Blepharitis, making an appointment with your eye doctor for an eyelid exam can help you know for sure. Visit ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠http://www.EyelidCheck.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ for more information.  Today’s episode is brought to you by Microsoft Dragon Copilot. Dragon Copilot is an AI clinical assistant that streamlines documentation, surfaces critical information, and automates routine tasks — empowering healthcare teams to focus more on patients and less on administrative work. Learn more at ⁠⁠⁠https://glau.cc/Dragon⁠⁠⁠ Produced by⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Human Content⁠ Learn more about your ad choices. Visit megaphone.fm/adchoices

It’s Christmas, which means two things: Kristin’s wearing a periodic-table tree shirt, and I’m reminiscing about the worst cafeteria meal in VA history (“brown meal,” may it never return). But the real adventure this week? Our kid suddenly developed mysterious brown patches on her skin, smooth, painless, and deeply unsettling for two parents whose medical degrees contain zero pediatrics. Cue the panic Googling, the advice nurse, and the pediatrician casually wiping it off with an alcohol pad like a magic trick. Then we dive headfirst into microbiology, where we rediscover that: Anaerobes “can’t breathe fresh air,” Encapsulated bacteria are the gym bros of the microbe world, andnd urease-positive organisms somehow got saddled with the mnemonic P CHUNKS. Takeaways: Terra Firma-Forme Dermatosis: The completely benign, extremely weird skin condition that wipes right off with alcohol. Holiday Clinic Life: Why no one wants their eyes dilated on Christmas Eve (except maybe for the sparkly lights). Anaerobe Mayhem: “Can’t breathe fresh air” and other microbiology mnemonics that should probably be illegal. Encapsulated Bacteria: The microscopic linebackers that even your spleen has strong opinions about. P CHUNKS: The urease-positive mnemonic you’ll wish you could forget. — To Get Tickets to Wife & Death: You can visit Glaucomflecken.com/live  We want to hear YOUR stories (and medical puns)! Shoot us an email and say hi! [email protected] Can’t get enough of us? Shucks. You can support the show on Patreon for early episode access, exclusive bonus shows, livestream hangouts, and much more! –⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ http://www.patreon.com/glaucomflecken⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠  Also, be sure to check out the newsletter: https://glaucomflecken.com/glauc-to-me/ If you are interested in buying a book from one of our guests, check them all out here: https://www.amazon.com/shop/dr.glaucomflecken If you want more information on models I use: Anatomy Warehouse provides for the best, crafting custom anatomical products, medical simulation kits and presentation models that create a lasting educational impact.  For more information go to Anatomy Warehouse DOT com. Link: https://anatomywarehouse.com/?aff=14 Plus for 15% off use code: Glaucomflecken15 -- A friendly reminder from the G’s and Tarsus: If you want to learn more about Demodex Blepharitis, making an appointment with your eye doctor for an eyelid exam can help you know for sure. Visit ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠http://www.EyelidCheck.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ for more information.  Today’s episode is brought to you by Microsoft Dragon Copilot. Dragon Copilot is an AI clinical assistant that streamlines documentation, surfaces critical information, and automates routine tasks — empowering healthcare teams to focus more on patients and less on administrative work. Learn more at ⁠⁠https://glau.cc/Dragon⁠⁠ Produced by⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Human Content⁠⁠ Learn more about your ad choices. Visit megaphone.fm/adchoices