A Crazy Medblog

Recession Proof

Sat, 25 Oct 2008 16:50:50 -0400

At breakfast this morning, one of my brothers from another mother educated me a bit on recession proof careers. He informed me that despite the economic woes that have decimated the value of our houses and stocks, cost thousands of jobs, limited our ability to borrow and reduced our incomes, NYC prostitutes are doing just fine! They are still charging the same for their services and are as busy as ever! You’ll recognize the picture above as Ashley Dupre, ex NY governor Elliot Spitzer’s infamous call girl, flashing the “piece” sign.

I had no reason to doubt him, but before posting, I felt a need to confirm sources. I found the original article in the New York Daily News, and dozens of blog posts about this.

Other recession proof industries were mentioned on the blogs. Among them are smoking, drinking, gambling and drug trafficking. And of course, being a doctor and knowing the medical business never slows down, I mentioned the health care industry is recession proof as well.

Hmmm. Sex, smoking, drinking, gambling, drug trafficking... and health care!?! What does that say about my industry!?!

Off the top of my head, I can think of famous health care prostitutes like these.
But when I think about it, the reality is that all doctors and patients are being pimped. And it’s not just by Oprah! We are victims of unspeakable crimes perpetrated by health insurance companies and large hospital systems, not to mention drug companies, etc.
They make all the decisions about access to the health care system, what will be covered, they set the prices, they determine how much they will pay out, and have gained control over all aspects of health care, at the local, state, and national levels. At the end of the day, they walk out with all the dough. Dough that should be used to either take care of patients, or to reimburse the good nurses, doctors, therapists, pharmacists, etc. who are actually doing the work. And these health care pimps have their pimp brothers in government. Bipartisan pimps.
And that’s why we are all still in “the life.” We have nowhere to go. If we try to get far out of line, patients and providers alike can expect to get bitch slapped by the powers that be.

What’s the answer? Death to the pimps! We don’t need health insurance companies. They suck the life out of us and provide nothing that couldn’t be managed without them. We need less government intrusion, not more. When has government intrusion ever provided a cost effective solution? We do not need closed, “integrated” hospital systems limiting our choices while lining their pockets with our hard earned money. We don’t need our elected officials protecting the perpetrators. We victims need a stronger voice from our leaders! We need more control over these basic services.

Power to the people!

So, I guess the sex, smoking, drinking, gambling, drug trafficking, and health industries do have something in common. Recession proof rapists of America.

Selective Hearing

Thu, 12 Jun 2008 12:42:44 -0400

“So what makes you think you have Parkinson’s Disease?” replied the doctor, observing the man’s tremor.

“I’ve developed this shake in my right hand and arm, and it bugs the hell out of me.”

After asking several questions and examining his patient, the doctor had some good news, for a change. “You don’t have Parkinson’s Disease. You have what is called a Benign Essential Tremor. Sometimes it is called a Familial Tremor because it tends to run in the family. It is a nuisance that sometimes comes with aging, but is not related to a major neurologic disease. We don’t have to treat it, but if it is so bad that you’re spilling your coffee, or if it is an embarrassment, we do have treatments that work nicely.”

“Well I don’t drink coffee, doctor, but I sure would hate to spill my beer,” he said with a chuckle. What kind of treatments are you talking about?

“This tremor responds to all sorts of different medicines, including certain drugs we use for high blood pressure, seizures, anxiety, and and pain. We can almost always find a simple solution with little to no side effect. Even alcohol helps. Though of course we don’t advise that. With alcohol you could end up with two problems instead of one. Do you want to just live with it for a while, or would you like me to prescribe something for you?”

“That’s alright. Thanks, doc. I can take care of it.”

Back home later that night, he finally noticed his wife when she repeated her question for the third time, this time with a louder and angrier tone. “... So what did the doctor say about your shaking?!”

“Oh, nothing much really. He said I have Parkinson’s Disease and that I should just live with it.”

“What?!” His wife was instantly upset at the doctor’s flippant recommendation for such an important illness such as Parkinson’s Disease. “Didn’t he suggest some sort of treatment, or a referral to a neurologist?!”

“No, but he said alcohol would help, so I’m taking him up on that!”

His wife did not think that was funny at all. But when the subject turned to alcohol, she had learned to just shut up.

He found out that a beer really did tone down the tremor. The doctor apparently really knew his stuff! And then he found that two beers helped even better. Three beers took the tremor entirely away.

After some time, he realized that three beers several times a day was not good for his beer belly. He became calorie conscious. For his own good health, he decided hard liquor might be better. Maybe the tremor would go away with fewer calories! Good idea!

Now lunch at the martini bar had become a regular thing. “Shaken, not stirred,” he told the bartender, in his best 007 impersonation, while the unimpressed bartender just rolled his eyes up in his head.

And martinis at home had also become part of his treatment program. It made sense to him that the shaking tremor of his right hand helped to mix his martini, and the martini helped the tremor. “Things could be a lot worse than having Parkinson’s Disease,” he thought to himself in all seriousness.

Oblivion

Tue, 3 Jun 2008 18:59:38 -0400

“Can you tell me what this is?” The occupational therapist waited a few seconds to see if Paris made any reaction. Her eyes were open. She was sitting nicely in her chair, apparently paying attention, looking at the object that had appeared in her field of vision. But she made no reaction. No response. No movement. No change in her expression, or lack thereof.

“Can you tell me what it’s used for? You used to use it every day!”
Paris looked at her therapist for a moment, then back to the object which her OT was now waving in front of her face. Not much progress in the past two weeks, but that did not seem to change the cheerful, optimistic tone in her therapist’s voice. After a few minutes of this, Paris began to lose attention. “It’s your hairbrush,” said the OT, in the happy way one might talk to a two year old, not to a sweet sixteen. “You use it to brush your hair like this...”

Two months before Paris had lived in a different world. She knew what a hairbrush was in that world, and how to use it. That was before the accident. No one had been there to witness her life changing event. No one knew why her car had gone over the curb and come to a sudden stop against an old oak tree. She had her new driver’s license with her, in her new little purse. There was nothing else in it. She had been wearing her seatbelt. She had not been drinking, or talking on her cell phone. When she was found, the only sound came from the crashed car’s radio, playing some old love song, playing to the deaf ears of her unconsciousness.

Her distraught mother sat at the hospital bedside for the next few days. She wept at the thought of her beautiful baby girl, with such a bright future ahead of her, a future now in question as the coma wore on to its third day. Family members and many of Paris’ friends sat vigil in the waiting room, in surreal disbelief. How could this have happened? It wasn’t supposed to happen. Why did God let this happen? Surely things would turn out fine in the end. Right? ... a jumbled mess of empathetic but useless thoughts.

Paris woke up, sort of, a few days later. For a short while, everyone was ecstatic. She was alive and awake! That was a wonderful start! But it soon became apparent that Paris was not entirely there. It was impossible at that time to realize that the Paris everyone knew was gone forever. In bad situations, even as time goes by, it is difficult for some people to rightly balance hope and reality. For the rest of her life, Paris’ mother would always believe that her old Paris would someday return.

The occupational therapist lovingly brushed Paris’ hair. Stroke after stroke. Paris clearly enjoyed it, watching in the mirror as her hair was being brushed. The OT then placed the brush in Paris’ hand and asked her to brush her hair. Paris looked at it... and that’s all. After a minute her hands dropped to her lap, still holding the brush. The OT thought she saw a faint smile on Paris’ face, and imagined a faint thought in her head, but maybe not.

Paris left the rehabilitation unit a month later. She had made a little progress. With some assistance and reminders, she could put on her clothes and even brush her hair. With encouragement, she could do simple tasks. On her own, there was little to no motivation. Yet she looked calm and settled. She was not anxious, angry, sad, or wanting. Perhaps she wasn’t happy either, but at least she did not appear to be suffering.

A few years later, everyone had settled into new routines. Paris’ old friends had moved on with their lives and no longer came around. Her mother had easily accepted her caregiver role, “for as long as it takes.” She had organized a small job for Paris as a bagger at the grocery store, where from time to time she would run into some of her old friends. They would say a friendly hi how are you, but had learned to not expect much by way of response.

And that’s that.

There are lessons here, right?
There is a purpose and a reason for those who are handicapped, right?
There’s more to this than just being at the shit end of the bell shaped curve, right?
The Spirit is at work, even in this, right?

I pray that someday I am given the wisdom to understand.

Lost - The Rainy Day Episode

Tue, 26 Feb 2008 19:52:32 -0500

People said Lilly was a great gal. The bees knees! And really good looking in her pictures, when she was 18 years old, back in 1945. She had just married Bill, right before he was shipped off to the war. He was fortunate to come back home, and return to her.

They led a happy and productive life, had kids and grandkids, and then Bill died. They had been together for almost 60 years, so when he died, something inside her died as well. Though she was rich with friends and family, life had Lost it’s purpose, and she started to decline.

At the most recent family get together, she was seen wandering aimlessly about, Lost. It was then that a little miracle happened. She suddenly brightened. She had spotted her young husband and lover in the crowd of strangers. She ran headlong into his arms, shouting “Billy! Billy!”

“I’m not Billy, grandma. I’m your grandson, Bobby.” The words confused her. The smile left her face, and she shuffled away, deflated. She sat down by the window, staring blankly at the rain outside.

Bobby felt bad about it. His grandma had really Lost it. Maybe he should have gone along with her and pretended to be young grandpa Bill, for her sake. But it was weird. No, he decided that giving her reality checks was the better thing to do. He sat down next to her and held her hand.

“Saving it for a rainy day,” she said softly.

“What do you mean?” asked Bobby, just making idle conversation. She looked at him with a playful look and said, “You know what I mean, silly. The money. The stocks in the safe.”

This time, Bobby decided to play along. “Come on, Lilly. Let’s go take a peek in the safe!” He had never heard of a safe, or of any money, or stocks. Grandma Lilly and grandpa Bill had led a frugal life, because of the Great Depression, or so he had heard. They didn’t like to spend money. They distrusted banks. They were always afraid of the next Great Depression.

Lilly’s eyes lit up again. She squeezed Bobby’s hand hard, and led him upstairs to the bedroom. He blushed as his family members pointed at them and made all sorts of joking remarks.

Once inside the bedroom, Lilly sat on the edge of the bed and looked eagerly at the bedside stand. The heavy, ancient thing had been there forever. Bobby opened the drawers but found nothing. Lilly smiled another playful smile. She got up and started to move the bedside stand away from the wall, exposing a wall safe! It looked heavy, old, black, with a spinning combination lock and a long handle. Bobby’s eyes widened as he thought, “What the hell?”

“Grandma, does anyone know about this?”

Hearing the word “grandma” momentarily threw her off, but she quickly regained her Lost imaginary youth and joyfully started opening the safe. She knew the combination by heart and had no trouble with the lock and handle. Inside, was a large manila envelope. Bobby was a little disappointed not to find stacks of old dead presidents.

Lilly pulled out the manila envelope and proudly handed it over to Bobby. He peeked inside to see a stack of documents that made no sense to him, though he did recognize the letters AT&T. The oldest ones were dated in the 1920’s, before the Depression. The stocks had become nearly worthless in the 1930’s. Then there were others dated in the 1940’s and 50’s.

Turns out the telephone company had grown a bit over the years. The stock had split many, many times. Even the company had been split and reshaped itself. And the Lost certificates had grown from a few hundred bucks to a crazy large fortune. Grandma Lilly was worth about 5 million dollars!

After that, Bobby didn’t mind it so much that Lilly confused him for grandpa Bill. She was quite generous with her money. For his part, and to his credit, he was kind and thoughtful towards his grandma. But he drew the line at the bedroom stairs. That was still weird.

Been Away, Working

Thu, 14 Feb 2008 16:04:37 -0500

Sorry to all my readers, but I’ve been busy working. Yeah, some of us have to work. : (

I’ve redone my practice website and included a blog for the benefit of my patients. I added it to my MyBlogLog list. Now that it’s up and running, I’ll have more time to come back to this one, which is my favorite. And it’s all because of you, my crazy readers!

I invite you to read my latest post on my practice site, a mild rant on the medical insurance industry:

Insurance Companies are Evil

Happy VD ! (I mean Valentine’s Day, though I do have some excellent gross VD pictures that I mean to share with you in the near future!)

Nice Shoes!

Mon, 28 Jan 2008 22:34:11 -0500

She lived a charmed life, “under a lucky star,” or so she always said. She was born to a poor family and barely had enough to eat. But Youki was one of those poor fortunates, somehow oblivious to reality. She was always happy. Even when she was forced to work long hours in the shoe factory as a young child, she found joy in her work and in her friendships. She was paid enough to buy survival rations of rice, and with a new pair of shoes once a year.

Her factory made exact copies of the latest shoe styles. They worked with materials that looked like the finest leathers. The shoes were “beautiful.” And so, Youki began her love affair with shoes from a very young age.

Like Confucius said, “Time flies when you’re having fun.” (Okay, maybe it wasn’t Confucius, but just shut up, this is fiction and I can write whatever I want!) The years zipped along until Youki found herself a grown adult. At 16 she had achieved her full height of 4’11”. Her skin was like beautiful, pale porcelain. She had fine features and dramatic cheek bones. Her small body was full of cheerful life. Her feet would forever fit into size 4 shoes.

Youki married at 17 and had two children before she was 20. It was a minor miracle that her small breasts made enough milk to sustain them. She would be forever amazed at how God could change her diet of rice and water into breast milk.

At 27 she lost her first tooth. Though she remained outwardly cheerful by nature, she could no longer whistle without a front tooth. She learned to ease the inner sadness of her lost beauty by saving for a new pair of shoes.

At 37, she fell and broke her wrist. Her grandmother fixed a splint for her. Grandmother’s wisdom came from the experience of many such broken bones. Youki learned to ease her pain again by thinking of a new pair of shoes. When she felt better, she went shopping with her mother and grandmother.

By the time Youki was 47, she had lost quite a few more teeth, and 2 inches in height. Her back hurt all the time. She struggled to stand straight. She could no longer stand to wear her beautiful high heels. It hurt too much to wear them. She didn’t know that the pain was due to another broken bone in her back.

At 57, Youki was no longer the beauty she had once been. She remained pleasant and cheerful, but for shorter intervals, as pain has a way of interfering with joy and serenity. Gradually, she took to walking with a cane, and spent more time sitting, resting her aching back.

But one thing remained a constant consolation in her life. Shoes! And now at 67, she became more appreciative than ever. The curvature in her spine had become severe. She had a very hard time looking up. Her gaze was permanently aimed to the floor by the question mark shape of her collapsed spine.

“Nice shoes,” Youki said to a thin young woman on her way to work, unable to look up into her pale, smiling face.

~~~~~~~~~~~~

Play the Crazy ”Got Milk?” Matching Game.

Thank God I’m Not Ugly

Fri, 18 Jan 2008 20:21:02 -0500

My first impression was that he was ugly. Remarkably ugly. I wasn’t being mean spirited, just factual. I’m trained to observe such things! I had never seen him before, so I assumed he had always been ugly. I need to keep reminding myself not to assume anything.

He had already self diagnosed a “carpal tunnel.” Indeed he had numbness of the palm of the right hand, the index finger, the long finger, and half of the ring finger. And it got worse when I tapped the palm side of his wrist, at the median nerve. Classic. But I was more impressed with his ugliness. Even his hands were ugly, like this:

So, naturally, I asked him if he had developed tunnel vision. He looked at me with a shock of surprise, but described how he could no longer see things off to either side. It was becoming very hard for him to drive. I told him that maybe he had a brain tumor. He laughed and said, “No thanks, doc. I think I just have a carpal tunnel, thank you very much.” But his smile went away when I didn’t smile back.

I made note of his coarse facial features, and his Neanderthal eyebrows. I asked him to take off his shoes and his feet looked like this:

Acromegaly this obvious is hard to miss. We quickly confirmed a very elevated blood level of growth hormone. Next, a CT scan confirmed the presence of the suspected pituitary gland tumor which was overproducing the growth hormone. It looked like this:

He eventually had a successful resection of this tumor. The neurosurgeon went up the nose and through the sphenoid sinus, like in the arrow above, to remove the tumor. Slick!

He stopped getting uglier. But his days as a leading man were over. Fortunately, he got the part of Igor (Eye-gor) in the Broadway production of Young Frankenstein (Fronkensteen). I’m a big fan!

~~~~~~~~~~~~

It’s a fictional story, Ted. Fiction! But you be the judge:

Hair Today, Gone Tomorrow

Wed, 9 Jan 2008 19:36:49 -0500

Brandy was looking forward to the next stop. New York was her kind of town. It was the guys! She thought of them more as fans than as customers. They seemed to really enjoy the show. But of course she would never refuse the $5, $10, and even $20 bills they would so generously stuff inside her bra and panties. That’s showbiz!

Every year, their nationwide tour would stop at this lovely theater in Coney Island. It was much better than the usual county fairs. She and her fellow artists and performers would do their thing, show their stuff, and receive the love and laughter of their adoring fans.

The group of performers was growing. All except the midgets, of course! Some of the originals were still around, including the Siamese twins, Tom Thumb the 2 foot “tall” man, Handsome Hans with the six fingered hands, and of course, her royal self. And they had gradually expanded to include fire eaters, snake charmers, the guy that hammers steel spikes up his nose, and the girl that eats and vomits razor blades. Amazing, creative individuals, all. And they were hoping to sign on the Boy with Balls on Chin for next year’s tour, if he could be released from his South Park contract.

In front of the mirror, she could not help but admire her own divine femininity. She ran her hands down her small waist and around her curvaceous hips. She approved of the lacy push up bra that fetchingly revealed her breasts and cleavage. She ran a brush down her long, thick head of hair, and then down her long, thick beard. She smiled as she thought about the next show. She knew all eyes would dart from her face to her body, and back and forth like ping pong balls. She knew their laughter and pointing would turn to admiration as they heard her Broadway singing voice. And she knew that the few who stayed to talk would leave with fond memories of her charm, her humor, and her knowledge of the world.

She was happy with the way her life had turned out. She was doing all the things she ever wanted: singing, and traveling, seeing the world. She was making good money. She had many friends, and a boyfriend who adored her. She was glad she didn’t have the medical evaluation her mother had wanted her to have. She didn’t want to be labeled with a hormone disorder, screwed up genes, or with ovaries full of cysts. She didn’t want to be labeled a freak. She was just... herself: a child of God and nature, a gift to the world, a warm, loving, beautiful girl with a beard.

~~~~~~~~~~~~

How well do you accept your own freakishness?

The River in Egypt

Thu, 3 Jan 2008 15:26:12 -0500

Betty had the irritating habit of always changing the subject. It drove her husband crazy. Every time he tried talking about her shopping habits, or about the bills, she would go off raving about something else. He wanted to talk to her about the drawer full of unopened bills he had just found, but he just couldn’t pin her down. Typical. He’d have to clean up her mess again!

Betty was a woman with a lot on her mind. She had to take care of the kids, the house, the laundry, the school projects, and had to drive to soccer and gymnastics practices, and piano lessons, etc, etc, etc. She kept the family calendar and arranged the social schedule. She didn’t have time to talk to her husband about his obnoxious obsession with the family finances. When he did, it seemed natural to just ignore it and to talk about the things that were really important. Men!

If her day wasn’t already busy enough, she had just gotten a call from her doctor’s office. The nurse wanted her to make an appointment to talk to the doctor about her mammogram report. They wouldn’t give her the results over the phone. The nurse said it was important. Recalling her aunt’s experience with breast cancer, Betty had a few moments of anxiety, but then decided she didn’t really have time for that. She would talk to the doctor, get the report, and be done with it.

The doctor walked into the examination room with a serious look on his face. He reviewed the recent events with her. “You came in last week for your routine yearly examination, and casually mentioned you had a breast lump. You then told me it had been present for about 6 months, and that it was growing.” Betty opened her purse, looking for her calendar. She couldn’t remember if soccer started at 3 or 3:30. The doctor proceeded. “Betty, your mammogram is very abnormal. There is a definite mass in the breast with all the appearance of cancer. There is virtually no doubt. You will need a biopsy to confirm it, and then we will have to talk about what to do about this.”

Betty responded with a burst of anger. “I don’t have TIME to talk to you about this right now, doctor. In case you don’t know it, I have 3 kids, 4 if you count my husband, a house, and a dog to take care of. I feel fine. Mammograms aren’t always right. My car needs gas and I need to buy groceries for dinner!” She quickly and abruptly walked out, outracing the nurse to the exit. She blasted out of the parking lot with thoughts of schedules and activities jumbling crazily in her mind.

By dinnertime, everything was alright. A well balanced meal was on the table, and she anticipated an evening spent in the normal routine of homeworks, laundry, and Law and Order.

In bed that night, her husband asked Betty about how it had gone at the doctor’s appointment. “I’m fine,” said Betty. She didn’t have time to talk about it. She rolled over and instantly fell into a sound sleep.

~~~~~~~~~~~~

I was in my forties before I realized how much I used denial as a coping mechanism. I used to be a pretty good procrastinator, too. I’m trying to quit.

Ferd

The Family Man

Sat, 29 Dec 2007 14:28:16 -0500

Harry Goodman had been a good man. Once upon a time, he loved his wife and kids, worked hard for his employer, enjoyed the company of his many friends, and played with the dog.

Now his soon to be ex-wife, sitting in church, wondered how it was that her life had all come crashing down.

Looking back, she remembered that it had started with small things, maybe a year before. He would forget to shave, and he stopped fussing about how he looked, which was unusual for him. He said things that hurt people’s feelings, and seemed to not care. Gradually, he had started laughing and giggling at odd times. And eventually, he started growling and barking during conversations. Yeah, barking!

At some point, he started going out after work. She never found out where he went. Then, he started rude and inappropriate behavior at work. He got fired for getting close to the pretty receptionist and dry humping her, several times. He started going to strip bars. And finally, he started in on his 10 year old daughter’s friends. That’s when she told him to get out! And that’s the last time she ever saw him. It was crazy! She hated him! He had dishonored and abandoned his family! She prayed to God for answers, but got none.

Harry lived on the streets for a few weeks. He ate whatever scraps he could scrounge. He grunted and screamed at passersby. He would often start with rhythmic pelvic thrusts at any old time, even dry humping a street post.

Exactly what happened on his last day will be forever a mystery. He was found beaten to death on a downtown street. Had he offended the wrong person? Was it gang violence? Who knew. - - - He was found with no identification, and would eventually be listed as a John Doe on the death certificate. The cause of death, as determined by the County Coroner at autopsy, was intracerebral bleeding, due to head trauma, associated with a large, untreated frontal lobe brain tumor. The coroner wondered if this had caused him headache or any behavioral changes before he died.

Good man Harry was buried in a plain pine box, in an unmarked grave, in a cemetery close to his family home. While across the street, in church, his wife and kids were dealing with their anger and hatred as best they could.

Happy New Year!

~~~~~~~~~~~~