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Heroes Behind the Counter & In Other Places

The Marvelettes in 1963 Patients are cool.   I did a colonoscopy on a hospitalized man who was saddled with the ravages of obesity, diabetes, sleep apnea and respiratory disease.  My partner had performed the initial consultation, and it was my task to bring light into a dark place by performing a colonoscopy.  I engaged in some conversation prior to the procedure, not simply to acquire relevant medical facts, but also to establish some rapport with a man I hadn’t met before, who I was poised to violate.  I learned that he was a navy SEAL decades ago during the Vietnam war, and enjoyed some leisure time in Cambodia then.  He mentioned that he was waterboarded during his training repeatedly and described it as a routine exercise.  Yikes.  When I was his age, I was dissecting a cadaver in medical school.  The most risk I faced was crossing a New York City street. Fast food workers are cool.  I stop often in the morning at a McDonalds near one of the community hospitals we s

Is Your Hospital Crooked?

I read an interesting piece this morning about a medical renegade who turned his back on one of the most powerful health care systems in the world.  It’s not easy to push back against a leviathan.  If I give you an oar, I doubt that you could change the direction of a cruise ship.  But sometimes, a single person can make a wall fall down.  Remember, the brave Chinese man who faced down an approaching tank in Tiananmen Square, which was captured on an iconic video?  On a lesser scale, an orthopedist, formerly employed by The Cleveland Clinic Foundation, decided that his Clinic bosses were preventing him from offering his patient’s the best medical care possible.  He fired them. "Let's blow this joint!" The Clinic, in a cost cutting move, restricted orthopedists to using artificial joints from only two device companies.  The surgeon had been using artificial joints from another company for nearly 3 decades, and he reported excellent results.  This orthopedic surg

Is the Medical Profession a 'Special Interest'?

Don’t expect this humble blogger to explain Donald Trump’s broad and sustained GOP support, if our most seasoned political pundits are flummoxed.   Why is this man with no prior political or governmental experience trumping all of his competitors? Is he ahead because he is right on, or is he leading because the competitors are way off? Like most folks, the conventional politicians are by and large an uninspiring lot who offer scripted screeds that are canned and calculated.  Indeed, most political junkees like me can almost orate their stump speeches, since they vary little from speech to speech. Trump Appears to have no 'Special Interests' The conventional candidates often rail against ‘special interests’, a pejorative term that conjures up an evil group that is possessed by greed that tramples over the public good to serve themselves.  I challenge you to identify a candidate who has not spewed vitriol against these nefarious ‘special interests’.   When they

Labor Day Honors All

It’s Labor Day tomorrow when we pause to honor those whose labor has laid down the scaffolding of this nation.  Are we all in agreement who the honoree is on this federal holiday?  Labor Day - A Sad Day for Cows Originally, the holiday was to honor the labor unions, organizations that emerged over a century ago as a response to unfair and unsafe labor practices.  I certainly honor the working man for their contributions. There are carpenters and electricians who work for themselves, not for  labor unions.  Is the holiday for them also? What about the rest of us?  I’m a physician.  I work hard and hope that I am making some contribution toward the public good.  Is this holiday for me also? Business owners and management work long hours, often beyond traditional shifts, to maintain the success of their companies.  Is this holiday for them? Artists labor long hours coloring canvases or sculpting provocative creations.  Should they work tomorrow or are they ent

Patient Survives Death Sentence - Medical Negligence?

Doctors do not know everything.    We make mistakes and mistakes in judgment.  Sometimes we make the mistake of speaking when we should keep silent.  At times, patients ask us questions that we can’t or shouldn’t answer; and yet we do.  It shouldn’t be our objective to force certainty into an issue which is amorphous and murky.  Here’s a response that I recommend in situations where certainty is elusive. “I don’t know.” I saw a patient for the first time when he was sent to me for a colonoscopy.  Prior to the procedure, we interviewed him to be acquainted with his medical history.  We are always particularly interested in the cardiac and pulmonary history, as these conditions impact on the risk of the procedures and the anesthesia.   This patient had a lung resection.   He related the details which left my staff and me aghast. “The doctors told me that I had cancer and would be dead in 3 months.” Of course, it is not possible for a spectator to imagine the horror o

Is Your Doctor a Spin Doctor?

We are in the Age of Spin as the presidential campaigns percolate along.  So much fun to watch!  It’s a performance in doublespeak, deflection and distraction that is so obvious, that even a person who knows no English can spot it.  I used to get exasperated when I would watch a politician dodge the question posed, but now I view it as pure entertainment.   I’m glad I made this transition, particularly since I live in Ohio where we will see more spinning than anywhere else. Spinning is an old profession. To those who are unschooled in spinning recognition, keep your ear out for these phrases which are classic spin initiators. ‘…what I will say…’ ‘The question we should be asking…’ ‘I have always said…’ Let me illustrate. Reporter:  Do you support the president’s Iran deal? Spinner:     The question we should be asking is why are we caving to the Ayatollahs? Reporter:  Do you support a path to citizenship for the 12 million undocumented immigrants?

Who Deserves Quality Medical Care?

We all should know the difference between a slogan and real substance.   One of these has size and shape while the other is just a shadow.   Why then, is the slogan so powerful? A slogan is one of the weapons wielded by the Guardians of Political Correctness.  They will point toward the slogan du jour, and then, with cameras rolling, demand to know if you support it.  Even a moment’s hesitancy will be taken as weakness.   Expect to see your waffling go viral for all to see, edited down and sans context.  Politicians Advised to Avoid Waffles. During a presidential election, this practice is omnipresent.  Mr. Bush, do you support fair trade ? Mrs. Clinton, is your immigration policy to give amnesty to all illegal aliens? Mr. Cruz, do you believe in the rule of law ? These questions cannot be adequately answered with a reflexive yes or no.   The slogans contained within these 'gotcha' questions point to complex and nuanced issues that need layered responses.