MD Whistleblower

Early on, when the first coronavirus infections starting springing up in the U.S, I wondered if these infections and the threat they posed were truly qualitatively different from seasonal influenza.   As I became more informed, I recognized that the health experts were correct; this is not the flu. I was not persuaded, however, by the high mortality rates which were initially quoted.   Even today, we will hear and read that mortality rate for COVID-19 may be 10 times higher than that of seasonal flu, which is in the range of 0.1%.  We simply cannot make such an assertion authoritatively. The truth is that may be grossly overestimating COVID-19 mortality for a simple mathematical reason – we simply don’t know the extent of infected Americans who have mild disease or remain asymptomatic.  With widespread testing, we will likely verify that the percentage of COVID-19 fatalities is much lower than originally thought.  In simple terms, the larger the population segment there is with m

This Independence Day is different from all others that I have experienced. We are so bitterly divided. We face the fury of a resurgent pandemic. We cannot even agree if wearing a face mask is the right thing to do. Tens of millions of Americans have been thrown out of work. Our politics is increasingly poisonous.  Anger and frustration over racial injustice has erupted. How do we move forward? Will we be able to celebrate the day with the 'bonfires and illuminations' that John Adams forecast? The Whistleblower ”I am apt to believe that it will be celebrated, by succeeding Generations, as the great anniversary Festival. It ought to be commemorated, as the Day of Deliverance by solemn Acts of Devotion to God Almighty. It ought to be solemnized with Pomp and Parade, with   Shews , Games, Sports, Guns, Bells, Bonfires and Illuminations from one End of this Continent to the other from this Time forward forever more.” John Adams

Several decades ago, Thomas ‘Tip’ O’Neill, who was Speaker of the House is associated with the adage, all politics is local .   In other words, caring for the needs of one’s constituents is the best strategy to preserve one’s political viability.   Of course, those were also the days when Democrats and Republicans – despite their philosophical differences – could argue and thrash out a deal.   Indeed, it has become political lore how Speaker O’Neill and President Ronald Reagan could capitalize on their personal chemistry to make progress for the nation. Those were the days. There is a different type of chemistry today that exists between Speaker Pelosi and President Donald Trump.   When they are mixed together, they form an unstable compound that is highly volatile and may explode. Instead of all politics is local , we now have all things are politics , a sad bastardization of O’Neill’s principle.   Now, as we are all so painfully aware, anything can be politicized, whic

Progress is a messy business.   The pathways that have led, and are leading, and will lead to societal change have not been straight shots.   The nation is now tightly focused on pursuing racial justice, which has entered the 401 st year of a journey that has yet to meet its destination.   You can site your own examples of necessary reforms that were the result of years or decades of struggles that have been wrenching, frustrating and even violent.   None of these successes and ongoing works in progress are easily accomplished.   It’s hard for folks to feel they must give up something, particularly if they do not feel personally responsible for the injustice that is being legitimately targeted.   The reform process is not clean and many friendly fire casualties often result.   We saw this when the nation become revolted after learning about the horrible and pervasive culture of sexual harassment that permeated many businesses and industries.   I felt that in this instance, and e

Protests for racial justice continued throughout the country. Businesses are racing to announce their corporate policies for justice and equality. New polling reports that a majority of American support the protests and the Black Lives Matter movement. Even military brass support renaming military installations named after Confederate generals.   New York City opened up showing bold determination to aim toward normalcy Over a dozen states are reporting increased cases of COVID-19. President Trump expressed that policy brutality is committed by a few bad apples. Attorney General William Barr and others denied that systemic racism exists in law enforcement.   Over 40 million Americans have lost their jobs.   Over 150 COVID-19 vaccine efforts are underway. Major League Baseball still has no agreement between owners and players because of the usual obstacle. HBO Max pulled Gone with the Wind because of its sanitized portrayal of slavery in the

In medical terms, the nation has been in status epilepticus – an unrelenting seizure - since the cruel and cowardly killing of George Floyd, an act of evil that we have all witnessed on tape repeatedly. First, there was the brazen killing of an unarmed man who was already lying face down in handcuffs while a police officer pressed his neck into the pavement.   All the while the officer’s hand was comfortably planted in his pocket, a casual pose that one might expect from an officer ambling down the street greeting folks passing by.   Three of the officer’s confederates hovered over the scene.   Was Mr. Floyd a flight risk?  While I am not a law enforcement professional, Mr. Floyd did not appear to be combative or resisting? This violence was perpetrated by one who was sworn to protect and serve all of us, including Mr. Floyd. Protests erupted throughout the nation and beyond our borders.   While Mr. Floyd's passing may have been the spark, the story started hundreds of

Not long ago, Telemedicine was something that I read about.   Now, it’s something I do.   Over the past weeks I have been evaluating patients over the phone from home.   It has been an adjustment, but it has been smoother than expected.   First, I have always thought that the physical examination is overrated.   Yes, I recognize that such a declaration constitutes medical blasphemy, but I stand by it.   Don’t extrapolate beyond my actual meaning.   I am not suggesting that the physical exam is superfluous.   Indeed, there are many circumstances when the exam is absolutely critical.   However, for a good bulk of the routine gastroenterology patients I see, particularly for those who are returning to my office for a follow up visit, the exam contributes little value. Here is a sampling of patient visits where the history alone is largely sufficient. A patient with years of chronic constipation returns to see me for a 6 month follow up visit. A new patient sees me to evaluate f