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Dealing with Angry People - Better to Do Right than Be Right

 The nation’s racial upheaval, particularly vis a vis law enforcement, has shown us the value of the skill of de-escalation.   A situation arises and several outcomes are possible, although some are clearly preferred.  The specific technique and approach utilized may determine the end result.  A range of options are often available.  What can make these situations so difficult to unravel afterwards is that an option that may lead to escalation may be deemed to be acceptable, according to the training protocol.  In other words, even the approach taken was acceptable, there may have been a better way. Obviously, we all endorse training and practices that has the highest probability of bringing calm to a potential combustible situation.    I expect law enforcement – the professionals – to pursue de-escalation as their default mode.   But, the citizenry can and should do its part to de-escalate.     If all parties share the desire for a calm denouement, then it is much more likely that t

Labor Day 2020

Labor Day is a time to pause, reflect and to thank all those who keep this nation vibrant. You are the guts of the country. Labor has battled many adversaries over the decades.  It has sparred with management.  It has railed against 'right to work' legislation.  It has struggled to compete against low wage workers in foreign countries. But this year it has been sucker-punched by the most formidable adversary that has ever entered the arena. And Labor is still reeling.  And, so are the rest of us. An enemy like no other It will be a slow grind, but it will lumber forward.  Yes, we will reach the other side.  How will we get there?  Of course, we will need our medical and scientific community to put the virus in its place.  And everyone will have a role to play.  But, the grit, sweat and determination of Labor will be a major force leading us out of the abyss.

Why I Don't Tell Alcoholics to Quit Drinking.

  I have seen many alcoholics during my gastroenterology career.   It is likely in the majority of cases that I was not aware of their abuse history.   Patients often deny or minimize their alcohol history when queried.   “Do you use alcohol regularly?” “Only socially.” At this point the physician and the patient engage in a linguistic tete-a-tete on the precise meaning of ‘socially’. Patients are more forthright about their habits when they have a medical condition that has a clear an obvious connection to alcohol, such as jaundice or liver injury.   And, if family members are present, they often serve as fact checkers and truth tellers. What is my approach to these patients?    Do I wave my arms and preach like an evangelist that they should throw their bottles away?   Do I tell them that they must quit or face medical damnation?  Do I threaten to sever them from my practice if they persist with their addiction?   I have adopted a rather different approach.   I do not advis