Yes, it's another poem. If you're not in the mood for Friday silliness, hit the delete key NOW. If you're in a different time zone or don't work on Fridays and you didn't get this until after Friday, you should have hit the delete key several days ago. (Good bye!) Usual disclaimers and conditions: My thoughts and opinions only, not those of my employer or anyone else. Released under creative commons; you are welcome to redistribute this without asking; attribute it to me, Fred King, if possible; if you make improvements I'd appreciate a copy. Etiology: one of our more brilliant ICU attendings said something that made me think "you're a better drug than lasix, heparin." Then I thought "Kipling." Well, I haven't kippled for years, so that didn't go anywhere. I settled on Milton Hayes. You can see the original text and hear Bransby Williams reciting it here: https://www.youtube.com/watch?v=E1IacBE11Yo. (Text and recording are public domain.) (I can hear a few more delete keys clicking. Farewell!) And so before I lose more people from my audience, I present without further adieu: The Green Light of the Yellow LVAD An unusual case of congestive heart failure following routine excision of a skin neoplasm There's a broken-hearted patient in the ICU tonight There's an ECMO standing vigilant but mum There's a man with CHF but they hope to put him right With the promise of an LVAD soon to come He is only fifty-one, but he toils in the sun He's a farmer in the fields of gold and green And while plowing up the rows he saw a mole that grows and grows For farmers can't be bothered with sunscreen So he sought a doctor's care, for the mole gave him a scare From the months and years of working on his farm And the doctor took a look in her diagnostic book Actinic keratosis on his arm I really must insist you need a dermatologist Said the doctor, go and see one right away So he found someone to cut, a doctor said to know what's what And was scheduled for the dawn of the next day The doctor hadn't had his coffee and his attitude was lofty I don't need to wash for such a tiny job The doctor didn't seem to care, worked with hands that were quite bare And cleaned up with a dirty cotton swab So the wound became infected and a skin graft was rejected All because the doctor didn't wash his hands If he'd washed and gloved and gowned, germs would not have been around As the proper rule of surgery demands Though packed with antibiotic his large colon was necrotic And he had to have a foot of bowel removed Then he got an ulcer peptic, and his bloodstream it was septic And the c diff by the smell was quite soon proved Then he lay in bed a while, in a coma dripping bile 'Til the doctor filled him in on what he'd missed Your EKG is now abnormal as an outcome of your mormel And you need to see a cardiologist Then they took him to the lab where a doctor named McNabb Placed catheters that fit to him to a T His ejection fraction's low and his blood it cannot flow To all the places that it needs to be We can make the patient grin if we put an LVAD in Though a candidate for transplant he is not His quality of life will improve without this strife His insurance comp'ny thinks it's worth a shot There's a broken-hearted patient in the ICU tonight There's an ECMO standing vigilant but mum There's a man with CHF but they hope to put him right With the promise of an LVAD soon to come Fred King Medical Librarian, MedStar Washington Hospital Center [log in to unmask]<mailto:[log in to unmask]> 202-877-6670 ORCID 0000-0001-5266-0279 Gosh, Mr Science, I don't understand that even worse than before you explained it! --Bob and Ray, in memory of Bob Eliot, 26 March 1923 -- 2 February 2016 MedStar Health is a not-for-profit, integrated healthcare delivery system, the largest in Maryland and the Washington, D.C., region. Nationally recognized for clinical quality in heart, orthopaedics, cancer and GI. IMPORTANT: This e-mail (including any attachments) may contain information that is private, confidential, or protected by attorney-client or other privilege. If you received this e-mail in error, please delete it from your system without copying it and notify sender by reply e-mail, so that our records can be corrected. Thank you. Help conserve valuable resources - only print this email if necessary.