Wednesday, November 25, 2009

I don’t watch the American Music Awards because I don’t appreciate what is now called music. Fortunately, I am completely out of touch with today’s music and most other things in our mixed up world. At this year’s awards ceremony, the rock star Adam Lambert shook things up with his homosexually explicit performance. His scheduled appearance on “Good Morning America” was cancelled because they couldn’t trust what he would do. He did make it onto the lower rated “Early Show.” I’m proud of “Good Morning America.”

There were a couple of encouraging things in the entertainment world this week. Taylor Swift won the main award at the American Music Awards. I even like her stuff and she seems like a wholesome, sweet girls who is very talented and writes much of her own music. I just hope she remains that way rather than becoming a dope, crazed freak with sunglasses. The other positive happening was that Donny Osmond won the top award on “Dancing With the Stars.” Maybe there is some hope for the entertainment world and for me.

My world of music died long ago with Elvis and The Beatles. I must admit that through the years I have come to like some of the Beatles songs and also some of Elvis. I generally hate rock music and I don’t even like the church music anymore. They no longer use hymnals in church. The words are projected on a screen and it’s the same verses over and over with ear shattering accompaniment.

I love my iPod because I have filled it with my easy listening stuff and selected classical pieces. I even have a little country western. This is what I listen to on the porch. The music is very relaxing and I figure the deer must like it also because a lot of them are attracted to the porch when it’s playing. Now that I think about it, I may play a little Adam Lambert and other trash rock stuff. That should scare the deer away and may be the best deterrent yet.

Monday, November 23, 2009

With all the new guidelines for medical screening every patient is going to need a private secretary to keep up with the multiple appointment times for checkups. Keeping up with an individual patient and when they are due for certain test is going to be an impossible task for the physician unless they have an army of secretaries and massive computer support.

More guidelines will come so the whole thing is going to get worse. Mammograms start at age 50 and need to be obtained every 2 years. Pap smears start at age 21 and are obtained every 2 year. Everything stops at 65 or 70 and the patient awaits the death panel to determine if they should receive any medical care. There are many other routine test for which new guidelines will be developed. Now it’s every 5 years for a colonoscopy. PSA test are now done every year and the length of time between cholesterol and blood sugar test is very variable. The whole ideal of CT scanning for early detection of lung cancer is a subject of debate and this will certainly be dropped. The frequency and need for osteoporosis screening is questionable. Even though the physical exam is of limited value, this is certainly going to be redefined as to the need and frequency. It’s a full time job just to keep up with all these studies and the various times they should be obtained. This is also not to mention the schedule for immunizations including flu, tetanus, shingles, pneumonia, etc., etc. The immunization schedule for kids is another complex subject that changes almost daily.

All this is more than any doctor can keep up with and still try to treat sick people. To compound the issue there will be a critical shortage of doctors with national health care and all the new folks enrolled and demanding care.

We do need healthcare reform but there are going to be a lot of problems with a government program. We do need coverage for everyone and the insurance and pharmaceutical companies are in great need of cleaning up their act. Fraud and abuse of Medicare, self-referral and medical liability are other major problems that account for millions of wasted dollars.

Life is pretty simple on the porch. I don’t dare call for a doctor’s appointment; they will just laugh when I tell them my age. All I can do is await the appointment with the death panel.

Friday, November 20, 2009

The news this week is about new guidelines for cancer screening. These guidelines are based on so-called evidence based medicine. This approach looks at not only lives saved but at the unnecessary or false positive results that leads to complications, anxiety and increased medical cost. It asks the question if the lives saved are really worth it. The panel of folks who developed the new guidelines didn’t have any real experts in the field to give their input. The new guidelines call for the start of mammography screening at age 50 rather than 40 and also state that women do not need to do self-examination. Experts in the field say that the new guidelines are wrong at that many lives are saved by the start of mammography screening and self-breast examination at age 40. My own experience which dates back to the literal start of mammography by Egan in the 1960’s also tells me that the guidelines will cost lives. I have personally detected many cancers under age 50 and these women are alive because of early detection. It is true that false positive results cause anxiety and are costly but it is a small price to pay for the lives saved.

The guidelines say that only 1 life out of every 1,904 screened will be saved whereas if you wait until 50 to start screening it is 1 life saved for every 1,300 screened and over 60 it is 1 life saved out of 500 screened. In other words it’s not worth saving the 1 out of 1,904.

With this statistical approach we could look at the airlines. There will be a couple of million people flying on Thanksgiving. Using the same number as the screening guidelines this would mean about 1,054 would die from flying this Thanksgiving. With this number the airlines would be closed and millions of dollars would be spent to protect that number and save the lives. I don’t know why we are spending so many billions of dollars on screening for terrorist who might board the airlines. We should eliminate this costly and inconvenient practice because the terrorist would probably only crash 2 or 4 airplanes a year. If we lost only a few thousand passengers a year this is still less that the projected loss from discontinuing the practice of screening mammography under age 50.

The government is going to love these new guidelines and with national healthcare we can expect many more recommendations of this nature. If we look at evidence-based medicine carefully we could eliminate about 80% of visits to the doctor each day and that would even save lives. Many more lives could be saved by eliminating tobacco and alcohol from the market and reducing the speed limit to 55 mph.

It’s not so bad being old and sitting on the porch. My spouse and I have already had everything and there is nothing left to screen for. We are just waiting our turn for the government panel that evaluates you at the end of life and will stamp my forehead with the do not resuscitate label.

Saturday, November 14, 2009

All the legal terms being used to describe the Ft. Hood killer are amazing. There were a room full of witnesses watching this guy kill 13 people and wound 30 others and the media and the lawyers have the nerve to call him a suspect. In the days of the old west he would have been taken to the nearest tree and hung for his crime of murder. Now days the authorities are reluctant to call this murder and excuses for his action will be made to protect the civil right of this homicidal monster.

They are now referring to the allegations against the defendant rather than saying this cold-blooded killer. The strongest term that has been used is perpetrator of the shootings. The news also refers to him as the accused.

It will probably take years before this horrific act and the killer are brought to trial. We simply can’t run the risk of violating this guys civil rights. The court will then hear justification for his actions, like he shouldn’t have been retained in the army because he didn’t want to kill the other scum in his homeland. It’s okay that he voluntarily joined the military and thousands of taxpayer dollars were used for his education. We are now about to waste thousands of more taxpayer dollars to try this grease ball.

Where is a Jack Ruby when we need him? In retrospect, Jack Ruby was probably right is killing Lee Harvey Oswald. Oswald might still be in prison if Ruby had not acted for us.

Another defense for this piece of trash is that he was acting for his God to rid the world of infidels and that his action was no more than the killing that is done in battle. Allah and the Holy Koran authorized him to go into battle to protect is brethren at home. He will probably have a jury made up of Muslims and Unitarians who will understand his point of view and acquit him. Then the US Government will pay him disability and a pension for the rest of his life because he was paralyzed in the line of duty.
I only hope that this swarthy murderer will meet the same fate that I wish for the deer who occupy my backyard and spoil the view from the porch. This deranged fanatic has certainly spoiled our view of Muslims and their part of the world.

Monday, November 09, 2009

My spouse is already in the kitchen getting ready for Thanksgiving. I did my part this morning. My job is to make the cornbread for the dressing. Cornbread making is my specialty. I was taught by the master when I was a child; my mother. Cornbread is the basic ingredient for the dressing that accompanies the turkey. Some folks prefer the dressing made primarily with flour. Yuk!!

Cornbread is like nectar from the Gods. God provided manna for the wandering Israelites when they left Egypt. Manna is supposed to come in the night with the dew. I can mix the cornbread up anytime and it goes with everything. God hadn’t discovered cornbread at the time of the exodus or he would have provided the Jews with this delicacy and they would probably have been a much less contentious bunch through the years. God had to wait until the birth of my mother before one of the great food discoveries, namely cornbread. Mankind missed out on a lot without cornbread. I could do without cell phones and even computers but not cornbread.

My favorite meals have been at home, not at some fancy expensive restaurant. There is nothing better than a meal of blackeyed peas, fresh homegrown tomatoes or a stewed mixture of okra, tomatoes and onions, all of course complimented with cornbread and iced tea. I like an evening meal or late night snack of nothing but cornbread crumbled into a big glass of cold milk.

My cornbread has an egg and buttermilk as a couple of the essential ingredients, so it’s probably bad for you. Who cares? I had rather cross over the River Jordon than be denied my cornbread. Like my little granddaughter said, “if it taste good it must be bad for you.” In the case of cornbread, I prefer the taste to good health.

As I sit on the porch and enjoy the aroma of the goodies being prepared in the kitchen, I noticed the deer getting closer to the house. If I left the door open, I’m sure they would be in the kitchen for a piece of that cornbread as it comes out of the oven.

Friday, November 06, 2009

The government will spend millions probing into the life of Nidal Hasan the Fort Hood shooter who took the life of 13 people and injured 30 others. I could save them a lot of money because I know his situation well. Having served in the military at Walter Reed and also having worked with various residencies and physicians of all types for over 50 years I can speak with some degree of authority.

I feel confident in the profile of this individual that I could construct. To begin with he is a Muslim who is indoctrinated with the beliefs of this religion. He believes that the rest of us are infidels and that it is a holy thing to take out as many Christians and Jews as possible even at the expense of his own life. He, of course, is totally opposed to our wars in Iraq and Afghanistan and certainly was not going to tolerate being deployed to fight against his brethren. The fact that he is an American citizen and has been a quiet neighbor means nothing.

He was a poor physician who didn’t fit into the mold of the average student in training. This has not always been the case, but currently his chosen field of psychiatry is a noncompetitive residency and attracts the poorest and most dysfunctional students. There are of course exceptions to this statement but Hasan was no exception, he was the norm. Some of the brightest students I have known have chosen psychiatry for a career but they are the exception. It is no surprise that he received poor residency evaluations and I’m sure he was a misfit throughout his entire training.

The fact that he was a major in the army means nothing. Doctors are promoted automatically because of time in rank and merit is not a consideration in the promotions process. He could have been a psychotic Adolph Hitler and still have made colonel.

The sad thing is that we allow dysfunctional people to complete residency training or medical school and even serve in the military. We are reluctant to dismiss these misfits because it’s too much trouble and there will be an army of lawyers down on us for violating the individual’s civil rights. As a result they continue to marginally get through and do much harm to patients and have the potential to perform a heinous act such as the massacre at Fort Hood.

That’s my analysis from the porch and I suspect it is completely correct. My recommendation is to turn off the ventilator and save the taxpayers some money.

Tuesday, November 03, 2009

Yesterday’s news reported about the financial problems of the movie superstar Nicholas Cage. Cage makes 20 million a movie with a whole string of movies like “National Treasure” to his credit. He has been a multimillionaire and has several mega-mansions scattered around the world. Cage is now in big financial trouble because his financial advisor has made off with all the money and left Cage in debt and owing 6 million to the IRS. It’s hard for me to feel sorry for a guy like that. Even though he owes all that money to the government he will probably get off without a hitch whereas I would be in jail for owing a hundred bucks.

Maybe I’m just jealous but all these multimillionaires are about to drive me to becoming a socialist. Of course the Wall Street gangsters and the CEOs of banks and big businesses are the worst. Ballplayers are also in the million-dollar club. They are a bunch of millionaires out there getting tackled, hitting a baseball or throwing a ball into a hoop. Perhaps I shouldn’t complain because there are a lot of folks in my profession who don’t see patients making megabucks.

It’s easy to understand why the masses who are doing the work finally revolt. I’m not one to march and carry signs but my revolt is to simply not see anymore Nicholas Cage movies and to stop watching some of the ridiculous ball games that don’t mean anything anyway.

Even the authors of some the books I read are in the multi-millionaire club as well as some of the musicians I enjoy. Folks like Mozart and other classic musicians were people of modest means or even poor. Most of the authors of the classic books were not wealthy and certainly not in the class of a pro ballplayer or a Nicholas Cage. No one has been in the league of the Wall Street gang.

To keep from getting angry with all of these overpaid thugs I guess I will have to restrict my reading on the porch to the scriptures and notes from my friends on facebook.