Margaret Bates Walker MD RMT

Gender need not be publicized on the crib card. It seems presumptuous of hospital personnel to "assign" a gender to a newborn unable to speak for him/herself. Newborns presenting with ambiguous genitalia seem to be even more rare now than they were 40 years ago. When an infant with ambiguous genitalia is born, hours may be consumed compiling enough information about the newborn's genes and imaging studies, and receiving replies from consulting specialists (endocrinologist, surgeon, etc) before the care providers and parents can arrive at the "best resolution of disparate data" and select the "gender of rearing" that seems to be most appropriate for the child. At our birth, each of us is potentially gender-fluid. Our "personhood" is indisputable and immutable. Our gender may be neither.

The following adverse event happened about 15 years ago, but it occurred on my overnight duty shift, so I can't forget it. Our NICU's norm then was an individual MD-concocted (with the help of a "home-grown" computer software-calculated) recipe every day for patients receiving IV al. The fresh recipe for the first 12 hours of the next 24 hour IV al "dose" was hung at 1800hrs. Around 2200hrs the RN observed something about the baby's behavior that concerned her (I forget exactly what.) She called me, and she continued to investigate on her own also. The baby looked more "puny" than was his norm, but otherwise his findings were non-specific. Among other investigations, the baby's RN did a bedside glucose determination. It was zero. We both were flabbergasted; the baby's bedside glucose was repeated, and again it was zero. A simultaneous "store-bought" laboratory glucose determination was also zero. We gave D25W, and followed blood glucoses which gradually improved. The first and second (not yet entered or hung for the baby, due to be hung at 0600 hrs the following AM) 12-hour IV al bags for that 24 hour period were analyzed by the lab. Instead of finding D15W as we expected from the written IV al recipe order sent to the pharmacy, NEITHER bag contained any glucose at all. It turned out that the pharmacist compounding the child's IV al had simply forgotten to draw up the concentrated dextrose aliquant needed in both IV al bags for that upcoming next 24-hour period. Ostensibly, the short-term followup of the baby was good. I wish I knew and could tell you the results of his Bayley and other developmental assessments over the long term.

Suggestion to Stefan: The two icons, for "has been read" and "unread as yet" are presently, for elder eyes anyway, too hard to distinguish. Ideally, the visual difference between the two icons should be widened. On the Munsell axes of color, the two icons ARE different both in hue and value, but for both color characteristics the "contrast" difference is too small. The icons are too similar both in hue (grey versus blue) and value (position on the light-dark grey axis; imagine a document of many colors rendered in black-and-white. At present the "value" of the blue unread icon is very slightly greater than the value of the "already read" icon.) This is my impression from finally, last night, being able to perceive that there was indeed a tiny difference between the two icons that I hadn't detected before, and therefore thought both icons were sinply useless decoration. The Forum of the online medicat transcription school I teach a bit on, MT Advantage Career Center uses the same hue of blue icons for both, however the two icons differ widely in value, and are easily perceived as different because their values are so far apart. I believe this presentation manner would be suitable for all viewers, even those with color vision handicaps. Another of the Forums on which I teach, The Professional Practice Network under the aegis of the AHDI (Association for Healthcare Documentation Integrity, formerly know as AAMT, American Association for Medical Transcriptionists,) distinguishes the two icons only by hue (unread is green, read is blue), but the two icons have same, indistinguishable, value. I have good color vision and can easily see the difference. But the same hue for all icons can make them indistinguishable even for folks with GOOD color vision when a screen image is copy-and-pasted, and printed out using a black-and-white printer. For that reason, it is more important that icon alternatives differ in hue than that they differ in color, considering all potential screen users and possible downstream uses to which the screen image it put, teaching being one example. Thanks for your patience, Stefan!

pardon typo: "nmemonic." Sorry. I'm suffering severely from "communication withdrawal" while I can't access my normal email! (And, Stefan, I apologize to you for having let you down on the prior task I promised to perform.)

(Due to "daylight savings time" with its autumnal "Fall back" of one hour, my time here is actually not 7:28 but 6:28) Nmenonic for the time changes here is "Spring forward, Fall back."

Oh, my stars and bars!!! (Oops, SE USA regional expression of astonishment) The change has already occurred! and retrospectively as well, although I haven't needed to reboot to see the change! Y'all at 99nicu are "G-knee-eye" (genii?)

Thanks both for the addy of your short manual, and for validating my urge to "poke around to find things." Unfortunately, as a result of doing so recently, I somehow disabled my ability to access the email in my in-box at all! All messages apparently have been moved from wherever they were before to somewhere within the bowels of Yahoo, which I am unable to access because I have not "registered" yet for Yahoo, they claim, despite the existence, For Years, of my Yahoo email account. (Go figure! lol) I am prevented from "registering" for Yahoo tonight because using both my email addys, all of my user names I can can come up with plus all my passwords that I am able to remember, they fail to "match" so my attempts to register with Yahoo have all been rejected. I did, though, "poke around" on this platform and I will be anxious to learn if I have been successful in updating the demographic data which is automatically with my name when I post. Probably the demo data display requires me to reboot my computer first, which I haven't yet done, but I'll do that now.....

(Please ignore this thread! After exploration with my "clicker," I stumbled into the fascinating photo.)

I don't know how to navigate to the photo of the premie showing the color change (in which direction? pale? blue? bright red?) in right arm and right upper anterior chest, but I'm certainly interested in taking a look at it. Thanks in advance for any "how to" instructions! :-)