Sunshine is priceless. Yesterday was a beautiful day here in Spokane. Today is set to be even better. There is no way to adequately describe all the positive things gained by a sunny day. It lifts the spirit. It makes you start thinking about planting a garden. It makes you more likely to take your best friend for a walk. Come on Bandit, I am not going to sit here at the computer and waste the sunshine.
Kayak Bandit
Tuesday, February 7, 2012
Wednesday, January 11, 2012
Treating a Nation of Anxious Wimps
Treating a Nation of Anxious Wimps
Emergency departments are distilleries boiling complex blends of trauma, stress and emotion down to the essence of immediacy: what needs to be done, right now, to fix the problem. Working the past twenty years in such environments has shown me with great clarity what is wrong (and right) with our nation’s medical system. It’s obvious to me that despite all the furor and rancor, what is being debated in Washington currently is not healthcare reform. It’s only healthcare insurance reform. It addresses the undeniably important issues of who is going to pay and how, but completely misses the point of why.
Healthcare costs too much in our country because we deliver too much healthcare. We deliver too much because we demand too much. And we demand it for all the wrong reasons. We’re turning into a nation of anxious wimps.
I still love my job; very few things are as emotionally rewarding as relieving true pain and suffering, sharing compassionate care and actually saving lives. Illness and injury will always require the best efforts our medical system can provide. But emergency departments nationwide are being overwhelmed by the non-emergent, and doctors in general are asked to treat what doesn’t need treatment.
In a single night I had patients come in for the following complaints (all brought by ambulance): “Smoked marijuana and got dizzy”, “stung by a bee and it hurts”, “got drunk and have a hangover”, “sat out in the sun and got sunburn”, “ate Mexican food and threw up”, “picked my nose and it bled, but now it stopped”, “just had sex and want to know if I’m pregnant.”
Since all my colleagues and I have worked our shifts while suffering from worse symptoms than these (well, hopefully not the marijuana), we have understandably lost some of our natural empathy for such patients. When working with a cold, flu or headache, I often feel I am like one of those cute little animal signs in amusement parks that say “you must be taller than me to ride this ride” only my sign would read “you must be sicker than me to come to our emergency department.” You’d be surprised how many patients wouldn’t qualify.
At a time when we have an unprecedented obsession with health – Dr. Oz, The Doctors, Oprah and a host of daytime talk shows make the smallest issues seem like apocalyptic pandemics – we have substandard national wellness. This is largely because the media focuses on the exotic and the sensational and ignores the mundane. Our society has warped our perception of true risk. We are taught to fear vaccinations, mold, shark attacks, airplanes and breast implants when we really should worry about smoking, drug abuse, obesity, cars and basic hygiene. If you go by pharmaceutical advertisement budgets, our most critical health needs are to have sex and fall asleep.
Somehow we have developed an expectation that our health should always be perfect, and if it isn’t, there should be a pill to fix it. With every ache and sniffle we run to the doctor, or purchase useless quackery such as Airborne or homeopathic cures (to the tune of tens of billions of dollars). We demand unnecessary diagnostic testing, antibiotics for our viruses, narcotics for bruises and sprains. And due to time constraints on physicians, fear of lawsuits and the pressure to keep patients satisfied, we usually get them.
Yet the great secret of medicine is that almost everything we see will get better (or worse) no matter how we treat it. Usually better. The human body is exquisitely talented at healing. If bodies didn’t heal by themselves, we’d be up the creek. Even in an Intensive Care Unit, with our most advanced techniques applied, all we’re really doing is optimizing the conditions under which natural healing can occur. We give oxygen and fluids in the right proportions, raise or lower the blood pressure as needed and allow the natural healing mechanisms time to do their work. It’s as if you could put your car in the service garage, make sure you gave it plenty of gas, oil and brake fluid, and then expect the transmission to fix itself.
The bottom line is that most conditions are self-limited. This doesn’t mesh well with our immediate-gratification, instant-action society. But usually that bronchitis or back ache or poison ivy or stomach flu just needs time to get better. Take two aspirin and call me in the morning wasn’t your doctor being lazy in the middle of the night; it was sound medical practice. As a wise pediatrician colleague of mine once told me, “Our best medicines are Tincture of Time and Elixir of Neglect.” Taking drugs for things that go away on their own is rarely helpful and often harmful.
We’ve become a nation of hypochondriacs. Every sneeze is swine flu, every headache a tumor. And at great expense, we deliver fantastically prompt, thorough and largely unnecessary care. There is tremendous financial pressure on physicians to keep patients happy. But unlike business, in medicine the customer isn’t always right. Sometimes a doctor needs to show tough love and deny patients the quick fix. A good physician needs to have the guts to stand up to people and tell them that their baby gets ear infections because they smoke cigarettes. That it’s time to admit they are alcoholics. That they need to suck it up and deal with discomfort because narcotics will just make everything worse. That what’s really wrong with them is that they are just too damned fat. Unfortunately, this type of advice rarely leads to high patient satisfaction scores.
Modern medicine is a blessing which improves all our lives. But until we start educating the general populace about what really affects their health and what a doctor is capable (and more importantly, incapable) of fixing, we will continue to waste a large portion of our healthcare dollar on treatments which just don’t make any difference.
Dr. Thomas A. Doyle is an emergency physician who practices in Sewickley, PA. He is the author of the forthcoming book “Suck It Up, America: The Tough Choices Needed for Real Health-Care Reform”
I took the liberty to copy this here. I like what he says. Thank You, Dr. Doyle.
Kayak Bandit
Tuesday, January 10, 2012
I'm On My Way To.......
I may be silly, but I did not go visit my daughter's and their families at Christmas or New Year. For that matter, It was before Thanksgiving that I was last over in the Seattle area. I really like the time I spend there. But, I prefer to spend time when their lives are running along on normal.
When you are a guest at someone's home and they have all the responsibility to entertain you and others, they have little reserve energy to sit for a long time and chat. They may be heading to the store to buy last minute presents. They may be double checking the cupboards to make sure they have all the ingredients to make the pies, potatoes, turkey, gravy and more. I like it best when you can casually wake up and go into the living area with socks and pajamas. If no one has beaten you to the punch, you can make a pot of coffee and go get the paper. In other words, just fit in.
I am headed to Seattle tomorrow. I know there will be open arms waiting for my hug. There is nothing better than an enthusiastic hug from a grandchild. It is even better than the delightful hug of your own child. Children do not hold back. They come running and actually do jump into the hug. I can hardly wait.
I suppose I will help build some contraption out of Legos. I will slightly exasperate the boys because I do not know all the tricks to make something fit perfectly. But, it will be evident they enjoy the "help" anyway.
I am hoping I will get some hand written booklets with pictures. The pictures will show the obvious similarities to their family and pets. I say obvious, tongue in cheek, because I miss the obvious until the author points it out. And only then can I see what should have been obvious.
I am hoping I get to read some of them to sleep. Oh, and isn't it great to study the face of a child or baby while they sleep? Holding a baby in your arms while they succumb to sleep. The soft breath, the twitching lip or when they react to an unexpected noise. Boy, am I lucky. I can hardly wait.
Kayak Bandit
When you are a guest at someone's home and they have all the responsibility to entertain you and others, they have little reserve energy to sit for a long time and chat. They may be heading to the store to buy last minute presents. They may be double checking the cupboards to make sure they have all the ingredients to make the pies, potatoes, turkey, gravy and more. I like it best when you can casually wake up and go into the living area with socks and pajamas. If no one has beaten you to the punch, you can make a pot of coffee and go get the paper. In other words, just fit in.
I am headed to Seattle tomorrow. I know there will be open arms waiting for my hug. There is nothing better than an enthusiastic hug from a grandchild. It is even better than the delightful hug of your own child. Children do not hold back. They come running and actually do jump into the hug. I can hardly wait.
I suppose I will help build some contraption out of Legos. I will slightly exasperate the boys because I do not know all the tricks to make something fit perfectly. But, it will be evident they enjoy the "help" anyway.
I am hoping I will get some hand written booklets with pictures. The pictures will show the obvious similarities to their family and pets. I say obvious, tongue in cheek, because I miss the obvious until the author points it out. And only then can I see what should have been obvious.
I am hoping I get to read some of them to sleep. Oh, and isn't it great to study the face of a child or baby while they sleep? Holding a baby in your arms while they succumb to sleep. The soft breath, the twitching lip or when they react to an unexpected noise. Boy, am I lucky. I can hardly wait.
Kayak Bandit
Monday, January 9, 2012
Parenthood
Today is January 9, 2012. What an amazing day. You see, forty years ago, Kathy and I headed to the hospital because contractions were beginning. We were at full term for the delivery of our first baby.
Since it was our first we did not know what to expect. Sure we had listened to the wisdom of our parents and friends, We were told what to expect from our doctor. We had attended Lamaze training. This is where you are taught to breath the right way. The men were instructed how to comfort and support our wives.
Nothing could prepare us fully for what was ahead. It was not the same as today. Today we could be calling important loved ones from our cell phone while on the way to the hospital. That is not the way it was. We called our doctor's office and explained where Kathy was at with her contractions. When it was appropriate, they instructed us to head to the hospital. Once we had called Louise, Kathy's mom, and started driving, we were alone until we pulled up to the emergency door at the hospital.
Once we were at the hospital, the contractions continued. There would be periods of quiet for Kathy, put then here would come another contraction. It tore me apart as she contorted with obvious pain during each contraction. The hardest part for me was realizing the contractions were not getting closer together as we had expected they would be doing. So, time extended into hours and the contractions were staying about the same. It was clear to me that Kathy was really getting exhausted. The nurses tried to convince us to employ the techniques we had learned at Lamaze. Kathy and I did not do so great at this.
Louise would relieve me in the Labor room. There were other families in the waiting room with us. Some were only in the waiting room a brief time until they left the waiting room because the expected baby was born. A quick delivery was not to be for us and one other couple. This man and I were about the same age. They were expecting twins. They too, were expecting their first. As the hours dragged on, we talked a lot. We aspired many of the same things. We were going to be parents. We wanted the best for our expectant babies.
Some time in the middle of the night, my new friend was summoned to the labor room. It was not the same summoning that previous times the doors had opened and a family name was called. The summon had a sadness to it. It caused me to worry for my friend. And, sure enough, we learned that his twins were still. No life could be detected for either baby. They had to take the babies by C section. And sadly, they did not survive.
Kathy continued to have regular contractions. After much time, the doctor decided to induce the baby. Once this happened, the process moved forward. The contractions were stronger and closer together. When the birth was imminent, the staff shewed everyone out. It was a brief time, and the staff came to the waiting room and invited me in the delivery room. Here is a picture I will never forget. My beautiful, radiant, proud, yet exhausted, wife with an adorable baby on her bosom. Soon, the nurse gave the baby to me to hold. The bond between my darling daughter, Stephanie Lyn was formed. It was magical. No words can describe holding the life that came directly from you. The miracle of new life is special.
This experience will forever be the highlight of my own life.
The depth of despair, by contrast was witnessing the loss to my new friend and his wife. I met him briefly as he was leaving the baby viewing room. He apparently had asked to go see the babies ahead of open viewing time. Back then, there were only certain times that the public could go see the babies all lined up in their cute little beds behind a glass wall. We recognized each other with knowing in our eyes. There were no words available. We passed by each other in silence.
Stephanie continues to be the blessing to me that she was when she was first placed in my arms. Tomorrow is her 40th birthday. Happy Birthday, Stephanie. Thank you Kathy for sharing with me to allow the birth of our two precious daughters.
If you find mistakes in this post, please understand the handicap of tears in my eyes.
Proud Papa
Since it was our first we did not know what to expect. Sure we had listened to the wisdom of our parents and friends, We were told what to expect from our doctor. We had attended Lamaze training. This is where you are taught to breath the right way. The men were instructed how to comfort and support our wives.
Nothing could prepare us fully for what was ahead. It was not the same as today. Today we could be calling important loved ones from our cell phone while on the way to the hospital. That is not the way it was. We called our doctor's office and explained where Kathy was at with her contractions. When it was appropriate, they instructed us to head to the hospital. Once we had called Louise, Kathy's mom, and started driving, we were alone until we pulled up to the emergency door at the hospital.
Once we were at the hospital, the contractions continued. There would be periods of quiet for Kathy, put then here would come another contraction. It tore me apart as she contorted with obvious pain during each contraction. The hardest part for me was realizing the contractions were not getting closer together as we had expected they would be doing. So, time extended into hours and the contractions were staying about the same. It was clear to me that Kathy was really getting exhausted. The nurses tried to convince us to employ the techniques we had learned at Lamaze. Kathy and I did not do so great at this.
Louise would relieve me in the Labor room. There were other families in the waiting room with us. Some were only in the waiting room a brief time until they left the waiting room because the expected baby was born. A quick delivery was not to be for us and one other couple. This man and I were about the same age. They were expecting twins. They too, were expecting their first. As the hours dragged on, we talked a lot. We aspired many of the same things. We were going to be parents. We wanted the best for our expectant babies.
Some time in the middle of the night, my new friend was summoned to the labor room. It was not the same summoning that previous times the doors had opened and a family name was called. The summon had a sadness to it. It caused me to worry for my friend. And, sure enough, we learned that his twins were still. No life could be detected for either baby. They had to take the babies by C section. And sadly, they did not survive.
Kathy continued to have regular contractions. After much time, the doctor decided to induce the baby. Once this happened, the process moved forward. The contractions were stronger and closer together. When the birth was imminent, the staff shewed everyone out. It was a brief time, and the staff came to the waiting room and invited me in the delivery room. Here is a picture I will never forget. My beautiful, radiant, proud, yet exhausted, wife with an adorable baby on her bosom. Soon, the nurse gave the baby to me to hold. The bond between my darling daughter, Stephanie Lyn was formed. It was magical. No words can describe holding the life that came directly from you. The miracle of new life is special.
This experience will forever be the highlight of my own life.
The depth of despair, by contrast was witnessing the loss to my new friend and his wife. I met him briefly as he was leaving the baby viewing room. He apparently had asked to go see the babies ahead of open viewing time. Back then, there were only certain times that the public could go see the babies all lined up in their cute little beds behind a glass wall. We recognized each other with knowing in our eyes. There were no words available. We passed by each other in silence.
Stephanie continues to be the blessing to me that she was when she was first placed in my arms. Tomorrow is her 40th birthday. Happy Birthday, Stephanie. Thank you Kathy for sharing with me to allow the birth of our two precious daughters.
If you find mistakes in this post, please understand the handicap of tears in my eyes.
Proud Papa
Sunday, January 1, 2012
New Year
Happy New Year!
Happy is not the perfect word. Yes, I want you to be happy. But, I want for many more positive things than just happiness.
I want you to have the best year ever. I want it to surpass the high time it was when you graduated from college. Or even better than when you hit your first home run. Or, landed a big fish. I want it to be better than hot cocoa after a sledding party.
I hope you achieve much this year. I want you to get advancements at work. I want you to get higher grades in school than in the past. I wish for you to achieve any/all of your resolutions.
I hope your days are enjoyable. I want the days repetition to not be a drag. Our daily responsibilities take up a lot of our life. May it be pleasant and fulfilling.
I hope your health is good. May you have good health to pursue anything that you desire. One's outlook is so often affected by their health. I extend this hopefulness to your family.
For those of us that like gardening. May your garden grow with beautiful flowers and vegetables. May you have more than enough to share with others in your life.
If you hunt and fish, may you bag that big one. I hope you will be sending me pictures of limits caught. For those who hunt with a camera. I hope you enjoy your outdoor experience. Outdoor time is always a big spirit lifting time for me.
I hope all your traveling is safe. Whether you are going to the store or on a major vacation, I hope you get to see much and return home safe and sound.
Above all, I hope you are snug, secure and cozy at home. Home is a wonderful place where we get to pursue all of our hobbies. It is where we entertain our friends and family. It is where we can be quiet and reflective. May your home be a very blessed place.
I hope everyone increases their interests in politics. We are at a place that needs improvement. I believe we Americans are Blessed. None of us dare take this Blessing for granted. God Blessed this Nation. We need to remember that this Nation is of the People. That means you and I. So for the Nation to continue to succeed, we the People need to be engaged in directing it toward that success.
I wish I could be with each of you to exchange a warm New Year Hug. But, let this blog be a virtual hug from your friend,
Kayak Bandit
Happy is not the perfect word. Yes, I want you to be happy. But, I want for many more positive things than just happiness.
I want you to have the best year ever. I want it to surpass the high time it was when you graduated from college. Or even better than when you hit your first home run. Or, landed a big fish. I want it to be better than hot cocoa after a sledding party.
I hope you achieve much this year. I want you to get advancements at work. I want you to get higher grades in school than in the past. I wish for you to achieve any/all of your resolutions.
I hope your days are enjoyable. I want the days repetition to not be a drag. Our daily responsibilities take up a lot of our life. May it be pleasant and fulfilling.
I hope your health is good. May you have good health to pursue anything that you desire. One's outlook is so often affected by their health. I extend this hopefulness to your family.
For those of us that like gardening. May your garden grow with beautiful flowers and vegetables. May you have more than enough to share with others in your life.
If you hunt and fish, may you bag that big one. I hope you will be sending me pictures of limits caught. For those who hunt with a camera. I hope you enjoy your outdoor experience. Outdoor time is always a big spirit lifting time for me.
I hope all your traveling is safe. Whether you are going to the store or on a major vacation, I hope you get to see much and return home safe and sound.
Above all, I hope you are snug, secure and cozy at home. Home is a wonderful place where we get to pursue all of our hobbies. It is where we entertain our friends and family. It is where we can be quiet and reflective. May your home be a very blessed place.
I hope everyone increases their interests in politics. We are at a place that needs improvement. I believe we Americans are Blessed. None of us dare take this Blessing for granted. God Blessed this Nation. We need to remember that this Nation is of the People. That means you and I. So for the Nation to continue to succeed, we the People need to be engaged in directing it toward that success.
I wish I could be with each of you to exchange a warm New Year Hug. But, let this blog be a virtual hug from your friend,
Kayak Bandit
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