MD Whistleblower

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 ...

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. ...

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 s...

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 ...

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...

Tomorrow will be a Memorial Day worth remembering.   Of course, its core meaning – to remember and honor those we have lost in the service of this nation – remains paramount.   I have thought over the years that the day’s essence has become blurred as the day has become one of family picnics and barbecues.   I confess that I have not sufficiently paused and meditated on the day's meaning in year's past as I think I should have.  I placed a small American flag on our front lawn today, the smallest of gestures to honor a very solemn remembrance.     But this Memorial Day is different.  To those of us like me who have never served, this may feel as close to a war atmosphere that we will hopefully ever know.  Lockdown.  Shelter in place.  Commerce shuttered.  Empty streets and concert halls.  Fear.  Desperation. Hope.  Propaganda.  Supply chain disruption. Heroes.  Victims.  Agony an...

A few months ago, most of us had never heard of an N95 respirator or mask.   I had never heard of it. It is an essential element of Personal Protective Equipment, or PPE, which we have all heard so much about. The N refers to ‘non-oil’, meaning that the mask should not be used in the presence of oil-based substances.   The 95 means that 95% of airborne particles are screened out if the mask is worn properly.   Keep in mind that 95% is less than perfect.   It means that the mask will fail 5% of the time.   And, if the mask is not worn with a tight seal, the efficiency percentage will drop further.   And, the mask wearer is instructed not to adjust the mask during use which will break the seal.   So, the 95% standard is likely under idealized circumstances.   As of this writing, I have only worn the N95 mask on two occasions.   My initial experience donning the mask was for a fit testing by an occupational health specialist to ve...