Thursday, December 31, 2009

It’s the last day of 2009 and as I look back on 09 it’s very scary and as I look ahead it’s even more scary. The threat of terrorism continues and the war in the Middle East has expanded. Our economy has suffered and the national debt has become an enormous burden for future generations. The coming year will see healthcare reform, that is much needed, but Congress has constructed a bloated monster. The planet will continue to melt and unemployment shows no signs of abatement.

I know of some folks who are preparing survival kits, including the purchase of property in the hope that they may sustain themselves in the event of economic collapse or a complete Muslim takeover. Unfortunately, there is no way to escape the approaching mayhem. Most if us have become soften city folks with loose of the ability to till the soil, dig a well. milk a cow or slaughter a hog. Being able to use a computer, text message and work the remote for the TV may not be the skills necessary to sustain us in the future. Even my fortifications on the porch are insufficient to weather the approaching storms. I have nothing but books and they have only made matters worse by giving me insight into the chaos which best describes today’s world. The only bright news regarding the books is that some of them also give us hope. Believe it or not, things have been worse according to some of the stories I read. The Revolutionary War, Civil War, Great Depression and World War II were also tough times and we made it through.

So, with the dawn of 2010 I am going to read those books that give me some hope for the future. I’m going to try and remain optimistic even about healthcare. It will be nice that many folks who are uninsured will have the security of knowing that they have healthcare coverage even though others are going to have to pay the tab and suffer some lose in their coverage. All of us will have to wait and be inconvenienced as we try to obtain care from unwilling and inadequate providers. I’m going to spend the next few months reading the 2000 page healthcare document so I can learn about my benefits and, more importantly, what has been taken away.

Anyway, Happy New Year! I hope 2010 is a better one for everybody except the deer in my back yard.

Monday, December 28, 2009

I love Christmas but I’m glad it only comes once a year. If it came more often than once a year I could become a Sumo wrestler because of the massive weight gain that results from my over consumption of all the great food. I also become disoriented at Christmas especially when it is on a weekday. I think everyday is Sunday and it takes me a couple of weeks to get straightened out. My emotions also take a beating. At times. I’m sad thinking of Christmases past and relatives and friends who have passed on and at other times I’m happy when surrounded by grandkids and all the joy and excitement they experience. If the season was extended I would also become a pauper because of the depletion of my bank account from the expense of gifts and other charities. It’s almost enough to make me a Scrooge but since I’m afraid of ghost I’ll just remain the same and try to use the next few months to regain my bearings and restore my health and finances.

At Christmas, my mind always takes a trip to London in the time of Dickens and the Christmas Carol and also to Baker Street with one of my favorite characters, Sherlock Holmes. One of Arthur Conan Doyle’s best stories about the great detective was “The Adventures of the Blue Carbuncle” which took place during Christmas. This year a new blockbuster movie about Sherlock Holmes is on the big screen. The movie is great but the character of Holmes has been changed somewhat to be in keeping with our more violent age and to attract movies goers who are accustomed to explosions and other acts of violence. The movie does capture the brilliance of Holmes but it makes him more of a slob and a much less formal person. Doyle’s novels depicted Homes and Watson as reserved English gentlemen of the Victorian Age. The movie did portray the eccentric nature of Holmes, which is barely understandable to the modern world of today.

Although, I loved the movie I still prefer to curly up in an easy chair to follow the adventures of the great consulting detective the likes of which have never been duplicated since that magical time in London in 1895 when the fog rolled in, the sound of the hoof beats of the horses pulling a hansom on Baker Street was heard from the window, Mrs. Hudson was hurrying upstairs with food and drink, Watson was in armchair before the fire reading “The Lancet,” Holmes was conducting and experiment or playing the violin and footsteps were heard on the stairs followed by a knock on the door introducing the new client and a fantastic adventure to follow.

The world of Sherlock Holmes is something I have loved since childhood and still enjoy on the porch. This Christmas I was again able to visit Baker Street in 1895 through the modern movie version about my hero.

Sunday, December 20, 2009

Pictured above is the first known Christmas Card sent in 1843. Christmas Cards are always a lot of fun. Unfortunately, they have become so expensive that we have considered abandoning the practice of sending cards. We try to buy a nice card and send a picture of our grandkids along with a short note about what has happened to us in the past year. All of this along with the postage has become fairly expensive.

I like to send the cards in hopes of staying in contact with friends from afar and in hopes of receiving a card from them. The Christmas card is about the only personal mail we now receive. I get a lot of e-mail but a personal letter or greetings by snail mail is pretty rare. Our post office box is full every day but all this mail is nothing but advertisements, catalogs and bills. The postal service claims that only 3% of mail is now personal letters and they are going broke in spite of the high postal rates. They are considering things like stopping Saturday mail service.

During WWII, when I was a kid, we sent and received a lot of personal mail. It was my job to go to the post office every day and most of the workers knew me. A lot of folks didn’t have a post office box and received their mail by general delivery. The postal workers knew everyone. I don’t think general delivery even exists anymore and nobody knows anybody. It cost 3 cents to send a letter when I was a kid. I enjoyed writing letters and when I went to college I wrote the girl who was to become my spouse everyday. She likewise sent me a letter everyday and that was the highlight of the day. When I was in school we even corresponded with kids from other countries. All this was great fun.

I loved going to the post office when I was a kid. It seemed like a magnificent building to me. There was a large mural painting on the wall and these murals have become famous in recent years. I even have a book of these old post office murals and it brings back a lot of memories. Christmas Cards were not a big thing in my childhood but letters were pretty standard and kept you abreast of friends and family. Phone conversations were not used very often except in the event of death. The personal letter pretty much covered all the needs for correspondence and exchange of news.

So, today I send only a few personal letters a year but still enjoy writing a friend. Most of my correspondence is now by e-mail or facebook. While sitting on the porch with my new Verizon cell phone that does everything I have even learned to text message and type with my thumbs.

Tuesday, December 15, 2009

I try not to put many notes in the blog about illness involving my family, although there is plenty to write about on this subject. I have been involved in the diagnosis and treatment of cancer for my 50 years in medicine and also on a personal basis with my own cancer for 12 years and more recently with my spouse and now my daughter. So, I’m pretty close to an expert on the subject. I have thought about writing some kind of book on the subject and if I did it would be about what cancer patients want to hear and what to say to a cancer patient.

First and foremost they want to hear encouraging words. They want to be greeted with a cheerful voice not some whinny, sorrowful, pitiful moaning that sounds like they are being greeted by someone who is consoling them about impending death.

Most cancer patients like to know that you and others are praying for their recovery and healing. Even the prayer message can get out of hand. My daughter almost became hysterical after a recent message from a church prayer group. She was sent a card by the group that contained an enclosure that was a “ticket to heaven.” The ticket contained a verse of salvation. It had the same effect of being sent a picture of your tombstone. It turns out that this was more like a cruel joke rather than a reassuring prayer.

Support groups can be helpful to the cancer patient but it’s not good to burden the person with stories of death and suffering. Each cancer case is almost unique and swapping stories is frequently not comparing apples to apples. The slightest statement can be misconstrued even though it was well meaning. My daughter was recently told by her oncologist that she had a 95% cure rate. When my daughter repeated this number to a friend the response was, “what about the other 5%.” It temporarily turned a very positive outlook into an imperfect and more dismal prognosis. There are few things in life that are 100%.

It’s not necessary to tell a cancer patient a lie, but hope may be possible even when a situation seems almost hopeless. I had a metastatic lesion to my liver from a colon cancer and when I was in medical school this was truly hopeless. But here I am on the porch 12 years after my original diagnosis, thanks to modern medicine and well meaning prayer. I’ve got my ticket to heaven without some scary reminder of impending death to produce unneeded anxiety. In short it’s best to talk about a good book, a sporting event or even Tiger Wood’s troubles rather than tell a cancer patient how your relative died of cancer or how its better if they switched to another hospital or doctor that is the best in the world because you recommend it.

Wednesday, December 09, 2009

Recently I had dinner with a few educators for the medical school. An educator is not someone who actually does the teaching. They consider themselves above a teacher. The educator is the one who determines the curriculum and various teaching methods. They make sure that goals and objectives are written for every lecture and they make out evaluation forms and other meaningless paper work that makes teaching unpleasant.

Anyway, these educators I met with were talking about teaching in the future and how much of it will be by the computer. In the future medical students may be largely home schooled. We are moving in that direction pretty rapidly because now when I give a lecture I am staring at the backs of computers rather than into the face of a student. The practice of medicine is also headed in that direction. The computer can ask all the questions and order the appropriate test and then prescribe the correction medication. There will probably be less medical errors and the cost of medical care will decrease. The educators also believe that social behavior and interaction between the patient and physician can be learned via the computer. This may be true because the computer is more warm and friendly than many of the physicians I have dealt with.

I sure miss the empathy and compassion of my old family doc. In retrospect he couldn’t do much but he made you feel good and confident that he was in charge and doing everything humanly possible to make you well. One good thing about the computer doc of the future is that I won’t have to wait three months for an appointment. He will always be at my desk or on the laptop wherever I go. No more talking to an answering machine when trying to get hold of the doc.

If you are wondering how the computer can do a physical exam; it can be done with a little ultrasound probe that plugs into a USB port. The exam will also be much more accurate.

Well, that’s the future of medicine. Cost should be reduced and accuracy improved when we take the human element out of the picture. It will be interesting to see what happens when the computer gets sued. The plaintiffs attorney will have to type in his questions. Settlements and awards will be interesting.

Just think, my porch will become a doctors office and hospital. The uses for the porch expands daily in this world of computers

Friday, December 04, 2009

The above picture has been sent to me by several friends and I couldn’t resist putting it on the blog. It is the picture of the year. Unfortunately, it’s not simply a joke but represents a major problem I have with my fellow man. Many times I have lifted up people and placed them on a pedestal only for them to fall off and cause me great disappointment.

Tiger Woods was one of the ones I thought might be a perfect hero but again I was wrong. He is just another human and a jerk. The fact that he is the number one golfer and a billionaire means nothing. The town drunk has better morals.

There have been many occasions in which I have helped someone either financially or to further their career and they turn out to be a disappointment and have even turned on me. I call them the Frankenstein’s I have created.

That is the reason I have come to expect very little from folks and withdrawn to my fortress of solitude on the porch. At least the deer don’t disappoint me, I know they are going to destroy my yard. I hope Tiger has won his last tournament. Always remember, scum always rises.

Wednesday, December 02, 2009

Ordinarily, things like the escalation of the war in Afghanistan, the struggling economy, healthcare reform legislation the financial crisis associated with the emerald city in the desert, Dubal, and the proliferation of nuclear enrichment plants in Iran would be top news that would scare us to death and get our attention. All of these news items have taken a back seat this week to more important matters like the crashing of a White House party by a couple of people with weird names and even of greater importance, the wreak involving Tiger Woods.

Tareq Salahi and his wife Michaele managed to slip through security and walk right in on a big White House party and be greeted by the President. They had their picture taken with folks like Joe Biden and apparently had a big time at the party. They pulled it off by being well dressed and just acting like they were celebrities and big shots, so security didn’t dare question their identity for fear of embarrassing themselves for not knowing this possible famous couple. It’s a great trick if you have the nerve to pull it off. It’s sort of like walking into a hospital with a white coat and a stethoscope around your neck and pretending to be a doctor; nobody would dare question you for fear of getting chewed out or looking stupid.

The biggest news of the week was Tiger Woods smashing his car into a fireplug while backing out of his driveway at 2:30 in the morning. This has been international news and everyone is wondering why he would do such a thing and not give an explanation of where he was going. There can only be one logical explanation. There was obviously a domestic dispute and he had such a burst of temper he blew it off by jumping into his car and gunning it out of the driveway right into the fireplug. There is only one reason for a domestic dispute at that hour of the morning and it most certainly had to do with sex or the lack of by his partner. He was like a raging bull looking for relief. He should of thought of a cold shower, but with matters like this you usually are incapable of thinking. The blood drains out of your brain into other parts of your body making thinking impossible. That’s the reason there are so many births in the world. The public is not going to stop inquiring about this story and all of Tiger’s affairs will now be aired and all sorts of women will be claiming they have been to bed with the golfing billionaire. Many other women in heat and in search of fame will be seeking his attention. His good guy reputation has been forever tainted and he now joins the ranks of most Hollywood celebrities. All of this because his wife had a headache.

It’s great just rocking on the porch and not having to worry about such matters at my age. I’m content to watch the social behavior of the deer and other wild animals in my backyard that is really not much different from our current newsmakers.