Septic Quotes

I got a shotgun and a backhoe and no one looks under a septic tank for a dead body. (Bubba)

Laugh now, cry later.

Anggap aja kamu ikan lele. Bisa berkembang biak di septic tank. Dia hidup bahagia di tempat sampahnya.

Pride is a wound, and vanity is the scab on it. One's life picks at the scab to open the wound again and again. In men, it seldom heals and often grows septic.

When I recollect her, I see a long list of colors, but it's the three in which I saw her in the flesh that resonate the most. Sometimes I manage to float far above those three moments. I hang suspended, until a septic truth bleeds toward clarity. That's when I see them formulate: THE COLORS RED: [rectangle] WHITE: [circle] BLACK: [swastika] They fall on top of each other. The scribbled signature black, onto the blinding global white, onto the thick soupy red.

I hadn’t just backed up the toilet; I’d made the septic tank flood the house.

I got a big hole to dig in my back yard for my septic system. Wait a minute... where did my freinds go???

my dormitory had been waiting to have its septic system replaced since before the Berlin Wall fell.

My extended family and I believe the child who walks alone is a festering wound which has turned the house septic. We are looking for the anti…septic.

My thoughts festered until my mind turned septic.

By the end of a short walk, the septic tip of a cane probably collects enough germs to destroy a small city.

If only one person in the world held down a terrified, struggling, screaming little girl, cut off her genitals with a septic blade, and sewed her back up, leaving only a tiny hole for urine and menstrual flow, the only question would be how severely that person should be punished, and whether the death penalty would be a sufficiently severe sanction. But when millions of people do this, instead of the enormity being magnified millions-fold, suddenly it becomes “culture,” and thereby magically becomes less, rather than more, horrible, and is even defended by some Western “moral thinkers,” including feminists.

A person in public without a mask during a pandemic is a walking septic tank.

DPRD atau DPR selama ini adalah septic tanc, tempat penampungan belaka. Negara ini sama sekali tidak mengenal empat pilar. Kami hanya mengenal satu pilar kokoh yang berkuasa: presiden.

...I'm as happy as a pig in mud, but I would have normally been as horrible, angry, and sad as a pig turned into bacon.

Sometimes the grass is greener on the other side of the fence because that's where your neighbor's leaky septic tank is buried.

My life is in the toilet, Red. We're talking a serious septic tank situation.

Dense urban environments may do away with nature altogether—there are many vibrantly healthy neighborhoods in Paris or Manhattan that lack even a single tree—but they also perform the crucial service of reducing mankind’s environmental footprint. Compare the sewage system of a midsized city like Portland, Oregon, with the kind of waste management resources that would be required to support the same population dispersed across the countryside. Portland’s 500,000 inhabitants require two sewage treatment plants, connected by 2,000 miles of pipes. A rural population would require more than 100,000 septic tanks, and 7,000 miles of pipe. The rural waste system would be several times more expensive than the urban version.

Ethanol is a volatile, flammable, colourless liquid with a slight chemical odour. It is used as an antiseptic, a solvent, in medical wipes and antibacterial formulas because it kills organisms by denaturing their proteins. Ethanol is an important industrial ingredient. Ethanol is a good general purpose solvent and is found in paints, tinctures, markers and personal care products such as perfumes and deodorants. The largest single use of ethanol is as an engine fuel and fuel additive. In other words, we drink, for fun, the same thing we use to make rocket fuel, house paint, anti-septics, solvents, perfumes, and deodorants and to denature, i.e. to take away the natural properties of, or kill, living organisms. Which might make sense on some level if we weren’t a generation of green minded, organic, health-conscious, truth seeking individuals. But we are. We read labels, we shun gluten, dairy, processed foods, and refined sugars. We buy organic, we use natural sunscreen and beauty products. We worry about fluoride in our water, smog in our air, hydrogenated oils in our food, and we debate whether plastic bottles are safe to drink from. We replace toxic cleaning products with Mrs. Myers and homemade vinegar concoctions. We do yoga, we run, we SoulCycle and Fitbit, we go paleo and keto, we juice, we cleanse. We do coffee enemas and steam our yonis, and drink clay and charcoal, and shoot up vitamins, and sit in infrared foil boxes, and hire naturopaths, and shamans, and functional doctors, and we take nootropics and we stress about our telomeres. These are all real words. We are hyper-vigilant about everything we put into our body, everything we do to our body, and we are proud of this. We Instagram how proud we are of this, and we follow Goop and Well+Good, and we drop 40 bucks on an exercise class because there are healing crystals in the floor. The global wellness economy is estimated to be worth $4 trillion. $4 TRILLION DOLLARS. We are on an endless and expensive quest for wellness and vitality and youth. And we drink fucking rocket fuel.

Instead of hating, my heart cries mercy! Mercy on me! Mercy on me! Mercy on me! It calls out to love in an attempt to save myself. I don’t want to be one of those people who live their lives with boils, septic wounds and broken bones bleeding inside.

He also remembered a comedy he had read in his youth called “The Deluge”, which claimed the next great flood would be caused not by water from the heavens but by the backing up and over flowing of all the toilets, latrines, cesspools and septic tanks in the world which would start chucking up their contents relentlessly until we all drowned in our own shit.

Twins are just two nearly identical drainage solutions. They are just a couple of septic systems.

The roof leaked and the toilet flushed with the kind of diminished enthusiasm that often precedes serious septic difficulties. She

The truth is like a septic tank and the smell will eventually get out no matter how hard we tighten down the hatch.

The Supreme Grand Master raised his arms. ‘Brethren,’ he said, ‘let us begin . . .’ It was so easy. All you had to do was channel that great septic reservoir of jealousy and cringing resentment that the Brothers had in such abundance, harness their dreadful mundane unpleasantness which had a force greater in its way than roaring evil, and then open your own mind . . .  .

she lay in bed, her system septic, her head swollen and black, her face unrecognizable, the poison in her body did its worst. At 4:30 a.m. on Sunday, September 4, her death came suddenly.

For two hundred years we had sawed and sawed and sawed at the branch we were sitting on. And in the end, much more suddenly than anyone had foreseen, our efforts were rewarded, and down we came. But unfortunately there had been a little mistake: The thing at the bottom was not a bed of roses after all; it was a cesspool full of barbed wire . . . It appears that amputation of the soul isn’t just a simple surgical job, like having your appendix out. The wound has a tendency to go septic. —GEORGE ORWELL Notes on the Way, 1940

Nurses have nerves of steel and the mind-over-matter proficiency of a Buddhist monk. If, for example, you haltingly inform a nurse that you have just passed what appeared to be a large part of your brain into the toilet, via the birth canal, the nurse will not gag but instead will admonish you for flushing it away before showing it to her. Blood, phlegm, and mucus—all things intrauterine or subdermal, septic or dyspeptic—are attended to with efficient grace by nurses, who are the underpaid soothers and healers in every hospital, all over the world.

In stories there were marches without weeping foot sores, swordfights without septic wounds that killed heroes in their sleep. In stories, when a giant was slain, it toppled thunderously to the ground. In reality, a giant died much the same way anything else did: screaming and shitting itself.

He is surrounded. Even the sealed cabin around him has grown septic with life. Everything is animate, green and encroaching. Dozens of millions of species seethe around him, few of them visible, even fewer named, ready to try anything once, every possible cheat and exploitation, just to keep being.

No death, no suffering. No funeral homes, abortion clinics, or psychiatric wards. No rape, missing children, or drug rehabilitation centers. No bigotry, no muggings or killings. No worry or depression or economic downturns. No wars, no unemployment. No anguish over failure and miscommunication. No con men. No locks. No death. No mourning. No pain. No boredom. No arthritis, no handicaps, no cancer, no taxes, no bills, no computer crashes, no weeds, no bombs, no drunkenness, no traffic jams and accidents, no septic-tank backups. No mental illness. No unwanted e-mails. Close friendships but no cliques, laughter but no put-downs. Intimacy, but no temptation to immorality. No hidden agendas, no backroom deals, no betrayals. Imagine mealtimes full of stories, laughter, and joy, without fear of insensitivity, inappropriate behavior, anger, gossip, lust, jealousy, hurt feelings, or anything that eclipses joy. That will be Heaven.

I grew up in extreme poverty,’ said Hari Das. ‘Like me, my father was a day labourer, who also did theyyam during the season. Today theyyam can bring in much more than labouring – in a good season, after expenses, maybe Rs 10,000 a month – but in those days earnings were very meagre; maybe only Rs 10 and bag of rice for a single night. ‘I lost my mother when I was three years old. She had some small injury – a piece of metal pierced her foot – but it went septic, and because she couldn’t afford a real doctor she saw a man in the village instead. He must have made it worse. Certainly he failed to cure her. She died quite unnecessarily; at least that is what I feel.

It was in the southwest area that the trailers had begun to move in, and everything that goes with them, like an exurban asteroid belt: junked-out cars up on blocks, tire swings hanging on frayed rope, glittering beer cans lying beside the roads, ragged wash hung on lines between makeshift poles, the ripe smell of sewage from hastily laid septic tanks.

My eyes sting. I bite my lip to keep the tears at bay, but my stupid body betrays me once again and I’m crying, I’m crying in front of him, and I hate him. I’m not mad at him—I hate him. For the way he’s treated me. For having the solid career I don’t. For concealing the politics of this damn septic tank of a project. I hate him, hate him, hate him, with a passion

The slippers in the story mean that everything you see and do and touch, every seed you sow, or don't sow, becomes part of your destiny...I met Hema in the septic ward at Government General Hospital in India, in Madras, and that brought me to this continent. Because of that, I got the biggest gift of my life - to be a father to you two. Because of that, I operated on General Mebratu, who became my friend. Because he was my friend, I went to prison. Because I was a doctor, I helped to save him, and they let me out. Because I saved him, they could hang him...You see what I am saying? I never knew my father, and so I thought he was irrelevant to me. My sister felt his absence so strongly that it made her sour, and so no matter what she has, or will ever have, it won't be enough. I made up for his absence by hoarding knowledge, skills, seeking praise. What I finally understood in Kerchele is that neither my sister nor I realized that my father's absence is our slippers. In order to start to get rid of your slippers, you have to admit they are yours, and if you do, then they will get rid of themselves. The key to your happiness is to own your slippers, own who you are, own how you look, own your family, own the talents you have, and own the ones you don't. If you keep saying your slippers aren't yours, then you'll die searching, you'll die bitter, always feeling you were promised more. Not only our actions, but also our omissions, become our destiny.

Cars do not reflect the character of a person. A car is tangible, while a soul is spiritual. How can one represent the other? If cars represent our character, then we should all be driving convertibles. Because people change depending on if things are good or bad, and so are as fickle as the weather. A car can never fulfill someone the way a solid friendship, memorable experience or a good lamb roast can.

You will experience a lot of imaginings as usually is for humans although we tend to pretend that all our thoughts are septic and moral. Feel comfortable with your thoughts. Trust me dear child, no human is spared from wild thoughts and you too will have them. Nothing should limit you my child. But the minute you decide to speak out your thinking or live them, you should be ready for the consequences too.

Or maybe,” Miriam seethes, “men swim in a septic pool of bad ideas about tough guys and big dicks, and they float there, soaking in it, gulping down mouthfuls of that shit, and it gets inside them, infects them, makes their blood go black and sour. Fathers take their sons and shove their heads down under the water, too, just to make sure they all get a taste. Maybe men are fucking broken. You ever think that?

Twelve strangers," he interrupted, "twelve citizens picked off the street. In this world we're unfortunate to live in, and especially in this septic isle we live on,where squalid politicians conspire with the squalid press to feed a half-educated and wholly complacent public on a diet of meretricious trivia, I'm sure it would be possible to concoct enough evidence to persuade twelve strangers that Nelson Mandela was a cannibal.

But when it has been shown by the researches of Pasteur that the septic property of the atmosphere depended not on the oxygen, or any gaseous constituent, but on minute organisms suspended in it, which owed their energy to their vitality, it occurred to me that decomposition in the injured part might be avoided without excluding the air, by applying as a dressing some material capable of destroying the life of the floating particles. Upon this principle I have based a practice.

Tank's body is stacked with the others by the hangar doors to be disposed. He's loaded onto the transport for the final leg of his journey to the incinerators, where he will be consumed in fire, his ashes mixing with the gray smoke and carried aloft in a column of superheated air, eventually to settle over us in particles too find to see or feel. He'll stay with us - on us - until we shower that night, washing what's left of Tank into the drains connected to the pipes connected to the septic tanks, where he will mix with our excrement before leaching into the ground.

In the course of an extended investigation into the nature of inflammation, and the healthy and morbid conditions of the blood in relation to it, I arrived several years ago at the conclusion that the essential cause of suppuration in wounds is decomposition brought about by the influence of the atmosphere upon blood or serum retained within them, and, in the case of contused wounds, upon portions of tissue destroyed by the violence of the injury. To prevent the occurrence of suppuration with all its attendant risks was an object manifestly desirable, but till lately apparently unattainable, since it seemed hopeless to attempt to exclude the oxygen which was universally regarded as the agent by which putrefaction was effected. But when it had been shown by the researches of Pasteur that the septic properties of the atmosphere depended not on the oxygen, or any gaseous constituent, but on minute organisms suspended in it, which owed their energy to their vitality, it occurred to me that decomposition in the injured part might be avoided without excluding the air, by applying as a dressing some material capable of destroying the life of the floating particles.

The earth had granted me a lifeline, by letting me siphon off some of the water that was on its way somewhere else. Because of me, there would be less water flowing into the Chattahoochee River: less for the speckled trout, less for the wood ducks, less for the mountain laurel that drop their white petals into the river every fall. There would be more water flowing into my septic tank, laced with laundry detergent, dish soap, and human waste. At that moment of high awareness, I promised the land that I would go easy on the water. I would remember where it came from. I would remain grateful for the sacrifice.

You’re just living a normal life — never been sick, never been unhealthy, and all of a sudden you are fighting for your life. And this is happening to individuals every day,” Thomas said. The infection went to her blood stream and bone marrow and caused septic shock and organ failure. After undergoing multiple surgeries including a bone-marrow transplant and a “never-ending cycle of antibiotics,” she survived the ordeal.1​➔​ Thomas survived relatively intact. Some don’t, losing limbs in a desperate bid to stop the infection from spreading and then living permanently debilitated lives. Others aren’t even that “lucky.” Denis

Because nobody brought that up to you?” “No, we had no idea that there were any problems that would suggest that.” Besides, as she pointed out later in her testimony, she was not an expert on poison. Dr. Henry testified that Peru was not mentioned in papers on tropical sprue, and that even where the disease was common, those who contracted it had lived in the area for a long time, at least a year. Typhoid fever didn’t fit either. “Even though it’s an acute infection, [it] does not cause a tremendous elevation of the white blood cell count.” Dr. Henry believed that Mike had been septic more than once during his three hospitalizations. Dr. Pam McCoy, the ER physician at the UK Medical Center, testified next. “I work with residents and medical students. I teach them how to work in an emergency department. And usually . . . I go see patients, they go see patients with me; we talk about how you see a patient in the emergency department, how you take care of people, how you put in stitches, that sort of thing.

Not long ago, Malthusian thinking was revived with a vengeance. In 1967 William and Paul Paddock wrote Famine 1975!, and in 1968 the biologist Paul R. Ehrlich wrote The Population Bomb, in which he proclaimed that “the battle to feed all of humanity is over” and predicted that by the 1980s sixty-five million Americans and four billion other people would starve to death. New York Times Magazine readers were introduced to the battlefield term triage (the emergency practice of separating wounded soldiers into the savable and the doomed) and to philosophy-seminar arguments about whether it is morally permissible to throw someone overboard from a crowded lifeboat to prevent it from capsizing and drowning everyone.10 Ehrlich and other environmentalists argued for cutting off food aid to countries they deemed basket cases.11 Robert McNamara, president of the World Bank from 1968 to 1981, discouraged financing of health care “unless it was very strictly related to population control, because usually health facilities contributed to the decline of the death rate, and thereby to the population explosion.” Population-control programs in India and China (especially under China’s one-child policy) coerced women into sterilizations, abortions, and being implanted with painful and septic IUDs.12

I don’t know what to do with you,” he said, his voice growing curt with anger again. “Deceitful little minx. I’m of half a mind to put you to work, milking the goats. But that’s out of the question with these hands, now isn’t it?” He curled and uncurled her fingers a few times, testing the bandage. “I’ll tell Stubb to change this twice a day. Can’t risk the wound going septic. And don’t use your hands for a few days, at least.” “Don’t use my hands? I suppose you’re going to spoon-feed me, then? Dress me? Bathe me?” He inhaled slowly and closed his eyes. “Don’t use your hands much.” His eyes snapped open. “None of that sketching, for instance.” She jerked her hands out of his grip. “You could slice off my hands and toss them to the sharks, and I wouldn’t stop sketching. I’d hold the pencil with my teeth if I had to. I’m an artist.” “Really. I thought you were a governess.” “Well, yes. I’m that, too.” He packed up the medical kit, jamming items back in the box with barely controlled fury. “Then start behaving like one. A governess knows her place. Speaks when spoken to. Stays out of the damn way.” Rising to his feet, he opened the drawer and threw the box back in. “From this point forward, you’re not to touch a sail, a pin, a rope, or so much as a damned splinter on this vessel. You’re not to speak to crewmen when they’re on watch. You’re forbidden to wander past the foremast, and you need to steer clear of the helm, as well.” “So that leaves me doing what? Circling the quarterdeck?” “Yes.” He slammed the drawer shut. “But only at designated times. Noon hour and the dogwatch. The rest of the day, you’ll remain in your cabin.” Sophia leapt to her feet, incensed. She hadn’t fled one restrictive program of behavior, just to submit to another. “Who are you to dictate where I can go, when I can go there, what I’m permitted to do? You’re not the captain of this ship.” “Who am I?” He stalked toward her, until they stood toe-to-toe. Until his radiant male heat brought her blood to a boil, and she had to grab the table edge to keep from swaying toward him. “I’ll tell you who I am,” he growled. “I’m a man who cares if you live or die, that’s who.” Her knees melted. “Truly?” “Truly. Because I may not be the captain, but I’m the investor. I’m the man you owe six pounds, eight. And now that I know you can’t pay your debts, I’m the man who knows he won’t see a bloody penny unless he delivers George Waltham a governess in one piece.” Sophia glared at him. How did he keep doing this to her? Since the moment they’d met in that Gravesend tavern, there’d been an attraction between them unlike anything she’d ever known. She knew he had to feel it, too. But one minute, he was so tender and sensual; the next, so crass and calculating. Now he would reduce her life’s value to this cold, impersonal amount? At least back home, her worth had been measured in thousands of pounds not in shillings. “I see,” she said. “This is about six pounds, eight shillings. That’s the reason you’ve been watching me-“ He made a dismissive snort. “I haven’t been watching you.” “Staring at me, every moment of the day, so intently it makes my…my skin crawl and all you’re seeing is a handful of coins. You’d wrestle a shark for a purse of six pounds, eight. It all comes down to money for you.

be careful how you lust after the other man’s green grass, because his grass may be green because it is growing over his septic tank.

It’s not fair,” he croaked. “I didn’t know their aunt was a vampire when I dumped her body in the septic field. How was I to know she’d burn to a crisp when the sun came up?

Is there any chance you’ll quit your job so we can do this in the open?” he asked gruffly. “I... What? Ha!” The sound escaped her in a burst of disbelief as her consciousness landed firmly back on the hard floor.” A gush of icy cheapness went through her as she absorbed the full impact of the scenario. This was what happened when you thought the grass was greener on the neighbor’s lawn. Turned out it was actually an overflow of the septic tank. She headed for the door.

Ni✝e Synesthesia Night has come, darkness peals Like thunder muffled in black velvet's fold. Shadows twirl like Ferris wheels, Click-clacking cobblestones wrought of gold. Light leapfrogs unobscured across avenues; Boulevards twinkle with rose perfume. Wind keens septic streets in crimson shoes, Dancing barefoot on a witch’s broom.

What is the differential diagnosis of septic shock? Non-infective disorders, such as acute myocardial infarction, pulmonary embolism or drug reactions, must be excluded. Toxic shock (e.g. toxic shock syndrome) can also present in a similar manner. What would be your

Cam … would you do something for me?” “Anything.” “Could you find some of that plant Merripen gave to Win and Leo for the scarlet fever?” He drew back and looked at her. “Deadly nightshade? That wouldn’t work for this, sweetheart.” “But it’s a fever.” “Caused by a septic wound. You have to treat the source of the fever.” His hand went to the back of her neck, soothing the tautly strung muscles. He stared at a distant point on the floor, appearing to think something over. His tangled lashes made shadows over his hazel eyes. “Let’s go have a look at him.” “Do you think you could help him?” Poppy asked, springing to her feet. “Either that, or my efforts will finish him off quickly. Which, at this point, he may not mind.” Lifting Amelia from his lap, Cam set her carefully on her feet, and they proceeded up the stairs. His hand remained at the small of her back, a light but steady support she desperately needed. As they approached Merripen’s room, it occurred to Amelia that Win might still be inside. “Wait,” she said, hastening forward. “Let me go first.” Cam stayed beside the door. Entering the room with caution, Amelia saw that Merripen was alone in the bed. She opened the door wider and gestured for Cam and Poppy to enter. Becoming aware of intruders in the room, Merripen lurched to his side and squinted at them. As soon as he caught sight of Cam, his face contracted in a surly grimace. “Bugger off,” he croaked. Cam smiled pleasantly. “Were you this charming with the doctor? I’ll bet he was falling all over himself to help you.” “Get away from me.” “This may surprise you,” Cam said, “but there’s a long list of things I’d prefer to look at rather than your rotting carcass. For your family’s sake, however, I’m willing. Turn over.” Merripen eased his front to the mattress and said something in Romany that sounded extremely foul. “You, too,” Cam said equably.

But what actually happened was, first, Horkman and I had to climb down our side of the ravine, which was hard because those guns are a lot heavier than they look, plus it was really steep. We both kept dropping the guns and falling down, so we ended up mostly sliding on our butts, which took a while. The Cubans tried to keep cheering, but after a while they realized they’d better pace themselves. Like every twenty seconds or so, one of them would go, “YI-YI-YI!” But you could tell they were losing the mood. Plus—I’m just going to come right out and say this—I had to take a shit. I mean, bad. Which is something that never happens in the movies. You never see Rambo take a shit. You never see whatshisname, the guy in those Bourne movies, Matt Damon, when he and his co-star hot babe are fleeing through some foreign city and he’s killing enemy agents with kung fu, speaking nine languages, hot-wiring a car and driving like a stuntman, etc., you never hear him say to the babe, “Geez, I’m sorry, but even though those enemy agents are, like, twenty yards behind us shooting at us, I need to make a pit stop, because if I don’t get to a toilet right now I’m going to turn this car into a septic tank.” That’s the way I felt, when Horkman and I got to the bottom of the ravine. I had a cramp in my gut like I was about to give birth to a walrus. I had no choice but to drop my pants right then and there. “What are you doing?” Horkman said. “What does it look like I’m doing?” I said. “You can’t at least go behind something?” he said. “Go behind what, asshole?” I said, because (a) there was nothing to go behind, and (b) Horkman is an asshole. “I don’t believe this,” said Horkman. He walked about ten yards and sat down on a rock, facing away. Thanks a lot, douchenozzle. So there I was, squatting, and I don’t want to get too specific here, but it was a severe firehose situation. I was splattering the gravel big-time, plus there was a certain amount of gas noise, plus you had the natural echo in the ravine. I don’t think this was what the Cubans were expecting in the way of military leadership. I could hear them up there talking about me, and then one of them went “YI-YI-YI!” definitely sarcastically, and then they were all laughing. Assholes. Like they never had diarrhea in a ravine. I firehosed for I would say a good three

As the legal abortion service began, the number of admissions to the hospital for septic abortion dropped

The body’s initial response to a noxious local insult is to produce a local inflammatory response with sequestration and activation of white blood cells and the release of a variety of mediators to deal with the primary ‘insult’ and prevent further damage either locally or in distant organs. Normally, a delicate balance is achieved between pro- and anti-inflammatory mediators. However, if the inflammatory response is excessive, local control is lost and a large array of mediators, including prostaglandins, leukotrienes, free oxygen radicals and particularly pro-inflammatory cytokines (p. 72), are released into the circulation. The inflammatory and coagulation cascades are intimately related. The process of blood clotting not only involves platelet activation and fibrin deposition but also causes activation of leucocytes and endothelial cells. Conversely, leucocyte activation induces tissue factor expression and initiates coagulation. Control of the coagulation cascade is achieved through the natural anticoagulants, antithrombin (AT III), activated protein C (APC) and tissue factor pathway inhibitor (TFPI), which not only regulate the initiation and amplification of the coagulation cascade but also inhibit the pro-inflammatory cytokines. Deficiency of AT III and APC (features of disseminated intravascular coagulation (DIC)) facilitates thrombin generation and promotes further endothelial cell dysfunction. Systemic inflammation During a severe inflammatory response, systemic release of cytokines and other mediators triggers widespread interaction between the coagulation pathways, platelets, endothelial cells and white blood cells, particularly the polymorphonuclear cells (PMNs). These ‘activated’ PMNs express adhesion factors (selectins), causing them initially to adhere to and roll along the endothelium, then to adhere firmly and migrate through the damaged and disrupted endothelium into the extravascular, interstitial space together with fluid and proteins, resulting in tissue oedema and inflammation. A vicious circle of endothelial injury, intravascular coagulation, microvascular occlusion, tissue damage and further release of inflammatory mediators ensues. All organs may become involved. This manifests in the lungs as the acute respiratory distress syndrome (ARDS) and in the kidneys as acute tubular necrosis (ATN), while widespread disruption of the coagulation system results in the clinical picture of DIC. The endothelium itself produces mediators that control blood vessel tone locally: endothelin 1, a potent vasoconstrictor, and prostacyclin and nitric oxide (NO, p. 82), which are systemic vasodilators. NO (which is also generated outside the endothelium) is implicated in both the myocardial depression and the profound vasodilatation of both arterioles and venules that causes the relative hypovolaemia and systemic hypotension found in septic/systemic inflammatory response syndrome (SIRS) shock. A major component of the tissue damage in septic/SIRS shock is the inability to take up and use oxygen at mitochondrial level, even if global oxygen delivery is supranormal. This effective bypassing of the tissues results in a reduced arteriovenous oxygen difference, a low oxygen extraction ratio, a raised plasma lactate and a paradoxically high mixed venous oxygen saturation (SvO2). Role of splanchnic ischaemia In shock, splanchnic hypoperfusion plays a major role in initiating and amplifying the inflammatory response, ultimately resulting in multiple organ failure (MOF). The processes involved include: • increased gut mucosal permeability • translocation of organisms from the gastrointestinal tract lumen into portal venous and lymphatic circulation • Kupffer cell activation with production and release of inflammatory mediators.

Tak ada yang lebih menarik daripada menyaksikan seseorang menyelam ke septic tank kotorannya sendiri.

Latent Needs The larger and more significant portion of the market is comprised of prospects who do have needs for your product or service, but haven’t yet recognized those needs. In QBS, we say that these prospects have latent needs. Latent needs are needs that do exist but haven’t yet surfaced as problems or desires. Prospects with latent needs fail to recognize that they are no longer satisfied with the status quo. As an example, suppose you and I were standing beside your car when suddenly we noticed that one of your tires was worn down to the cords. Instantly, you would have a need for new tires. The question is, did you have a need for new tires yesterday? Sure you did. The tread on your tire didn’t wear itself down overnight. But until you actually recognized the existence of a problem, your need for new tires was latent. It existed, although you were not aware of it at the time. This is essentially what happened when Brent called me. I absolutely had a need for septic tank improvement products, but my need was a latent need. Salespeople encounter prospects with latent needs all the time—especially prospects who say things like: “I don’t need life insurance because I’m not planning to die any time soon.” Or, “We don’t have time to evaluate new technology, because we’re too busy putting out fires.” Here’s my personal favorite: “We can’t afford sales training right now, because sales have been slow.

The light indicating the bathroom is occupied clicks off and the fabulous Gigi Fandone saunters back to stage side. A heavy smell follows her. It's a smell much like the trenches in the zoo, but worse. It's a smell much like Detroit's septic system, but worse. It's a smell much like a diaper disposal truck, but worse.

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