Facts about the US Health Care System:
1)  # Uninsured in the US = 44 million (18% US populatin)
2)  # of extra lives lost in uninsured population when matched to insured (Institute of Medicine) = 18,000+
3)  %GNP from US Health Care Costs = 14%
     Next highest (Germany) = 8%
4)  % growth of MD and RN jobs since 1970 = 100-150%
     % growth of adminstrative jobs in health care since 1970 = 2500%
5)  % overhead of typical for-profit health care organization (eg HMO) = 30%
     % overhead of typical non-profit health care organization = 20%
     % overhead of Medicare = 5-6%
     % overhead of Canada's single-payer health care system = 1-2%
 

October 22, 2003

Recent quotations by attendings:
1)  "Call-Light Queens" = patients on the orthopedics ward.  Since all the older women with hip replacements can't get around, they hit their call-light buttons like they're playing those old Nintendo games.
2)  "You guys (med students) are like medical detectives.  Just like CSI Miami.  Except you don't drive fast cars or work with sexy people."
3)  "The difference between Strep viridans and Staph aureus in endocarditis is aggressiveness.  It's the like the difference between the Germans and Italians in world war II.  They're both aggressive, but the difference is the 'pee-in-your-pants' factor."
 

October 18, 2003

Doomed from the start:  Cubs, Red Sox

Nothing going on... just working outpatient clinics this past and next week and trying to study for my repeat family med exam in three weeks.  I did watch Finding Nemo for the first time yesterday... good flick.  Actually glad the cubs and red sox both lost this week -- now I have no reason at all to watch the world series.... and actually can get some work done.  ha
 

October 15, 2003

Breaking News:  First Starbucks coffee shop in Toledo opened this past week.  Interpret this as you may.

Film Review -- Kill Bill:  Great film.  Hilarious too.  Tarantino does a nice job with this tribute to/parody of Japanese cinema and anime.  I think you have a greater appreciation of the flick if you've watched enough that stuff to understand the cultural, genre, and thematic characteristics that Tarantino incorporates into the film.  I read that he even used a leftover set from an old Godzilla movie.  ha ha.  I only wish that I could understand the Japanese dialogue.  Nevertheless, even if you miss all that, the fight sequences are well choreographed and the sets/costumes are great.  In particular, I really liked his use of color and was impressed with how he was able to translate some typical anime scenes into live action.
 

October 12, 2003

My weekend:

At 46 acres, apparently, the largest corn maze in the world.  Impressive, huh?  Took us 2 hours to find all 10 or so stations in this thing.  whew... man, you really haven't lived until you've made your way through a gigantic corn maze... ha ha
 

October 10, 2003

Hospice:  I finished my two weeks at Hospice today.

The first thought that comes to mind is that it was much less difficult emotionally than I expected.  One of my patients died one morning, several hours before I arrived.  But, I really didn't react... more ambivalence than anything else...  I never had a personal attachment to this patient in particular since she was unresponsive through the entire time that I followed her.  I take back my original statement.  I think my strongest reaction was that of peace... You see how many of these terminally ill patients (some within days of arrival) are suffering through pain and delirium... and, all the difficulty family members have seeing their loved one in these states... so, there's a sort of... relief?... satisfaction?... can't find the right word... when they die peacefully...

The saddest thing I've seen are people who can not find peace before they die... it's people who can not find satisfying answers to the questions regarding what gives their lives worth, what happens after death, how much broken relationships affect them, and how to face the fear of dying alone... I mean, there have been some pretty close to utter despair... these are very predictable problems, but still... very sad.  Very sad when people find emptiness at the end of their life.

The most heartening thing I've seen are families coming together to spend days and weeks with their dying family member.  I never saw friends or significant others of my patients... it was always spouses and parents and siblings and children and cousins that took off weeks from work or travel across the country and would sit for hours and days in a patient's room... even when they were totally unresponsive... It was all very... impressive.

You know, I really hope that I continue to have moments of introspection from being a physician... there's always a danger of being desensitized to all the stuff that you see as a health care provider, but, already, there has been such incredible value for me in acting in a capacity not much greater than an observor these past two weeks...  just be to able to reflect on the value of family... of relationships and reconciliation... the assurance of Christ's presence in my life and physical death...

Other stuff:  Went to a small corn maze with some of the Christian Medical Fellowship people today... all 1st and 2nd years, so no one I knew at all... but, it was really encouraging to talk to people who share a vision for medical missions... some full-time even!  But, it has generally been so rare for me to meet any Christians who had similar visions for their professional and service and ministry lives as me... It was refreshing to hang out with these guys... even if all the girls were either married or much too Midwestern for me... ha ha

Bible study update:  Finally did Romans 12 with Brian.  That was pretty heavy stuff.  Actually, our conversation and my subsequent musings on that and other stuff kept me up pretty late last night...

Stupid comment of the day:  You know, I don't mean to keep on complaining about race issues, but when people say stuff like this........
Jan Stephensen, LPGA:  ``This is probably going to get me in trouble, but the Asians are killing our tour. Absolutely killing it. . . .  Their lack of emotion, their refusal to speak English when they can speak English. They rarely speak. . . .  We have two-day pro-ams where people are paying a lot of money to play with us, and they say, 'Hello and goodbye.' Our tour is predominantly international and the majority of them are Asian. They've taken it over.''

Hey, SD, I'll giver her credit that she was at least current with lingo enough not to say "oriental"... ha ha
 

October 6, 2003

Quote of the day:  "There are a lot of factors behind our start to the season, but one of them has been that we've had bad press - there has been a lot of negativity surrounding the club. . . . The players want to stick two fingers up everybody."  Chris Coleman, manager Fulham Football Club.

The US women lost in the semifinals of the Women's World Cup... the SF Giants got booted out of the baseball playoffs... the Oakland A's are in danger of blowing their third straight playoff series... I failed my Family Med exam... what a crappy weekend.

Also, what's the deal with Israel dropping bombs in Syria?  Sounds like a great idea to me, guys...  Man, I'm just waiting for Israel to drop into the Mediterranean and the rest of the Middle East and Arabian penninsula to go up in flames...

The only bright spot from this weekend was that I'm still in first place in my fantasy football league.  whee.

So, one of my patients at the hospice is getting better... no kidding.  she may be discharged with home care or to a nursing home in the near future... how crazy is that?  I'm raising the dead... I think I deserve to graduate from med school just for that... it's a bit hard to talk seriously about her... all those Monty Python's Quest for the Holy Grail lines keep on popping in my head everytime I walk into her room... "I'm not dead yet"... "I'm getting better"... "I feel like going for a walk"... "I feel happeeeee!"

Another of my patients may not make it through this week.  She's not doing very well.  One of my friend's patients died this AM... We'll see how things go...
 

October 3, 2003

It's official:  I'm a retard.  Yup, I totally bombed my Family Medicine SHELF exam... let's see.  Got a raw score of 61 (out of 100) which worked out to the 2% percentile.  Pretty amazing... I don't think I've ever been 2nd percentile for anything, ever... And, it's not as if I had any major problems or distractions... in fact, I started studying for family med before starting the rotation!  What a bummer.  I think the sheer magnitude of my failure makes it easier (and a bit more amusing) to take... I mean, you really gotta work to score less than over 2 standard deviations below the mean... wow.  So, to celebrate this unique event in my life, I'm going to a friend's place to have a Fuller's London Pride in a bit...

As far as my grades are concerned, I just have to retake the stupid test... although obviously I won't be able to get a grade higher than a putzy Pass for the rotation, the failed test won't reflect on my transcript or anything...  Kind of dampens my gung-ho 3rd year rush.  I was trying to think of a good analogy -- kind of like, starting a drag race wwith the parking brake still on...  A bit worried about how my Pediatrics test went since I thought I did better than I did on Family... and a bit bummed that I won't be able to ace 3rd year to make getting into Emergency Medicine easier...

Pretty damn annoying...
 

October 1, 2003

I started my two weeks at the Hospice of Northwest Ohio.  It's actually nice to spend a couple weeks almost purely on the humanistic side of medicine.  Although we haven't even done much in the first two days, it's shaping up to be a fairly emotionally tough couple weeks.  I'm not sure how long any of my three patients will live.  It's difficult seeing people and their families come to grips with death... at the same time, seeing the relief and peace that they often find... is pretty incredible.  It's experiences like this that make me appreciate that, in being a physician, patients allow me to share in the most personal moments of their lives... it's quite a priviledge.
 

September  29, 2003

Tigers Update:
The Detroit Tigers won 4 of their last 5 games to avoid becoming the worst baseball team in history.
How terrible they were...
Why they weren't that bad...
 

I'm starting off with two weeks of Hospice and then two weeks of Ambulatory.  Going to be a pretty chill month... so gonna try to take advantage of what little decent weather is left and try to work on my golf swing.  =)  Also, gonna to volunteer at our school's free clinic while I have the time to.  Ah, what a terrible life to live -- so much free time!  ha ha ha

Current Rotation:  Medicine,  Ambulatory and Hospice at MCO

Last meaningful leisure activity:  Cedar Point last weekend.  First time I've been to an amusement park in like 2-3 years... I think it gets more fun the older I get... ha ha
Current books I'm reading: Neuromancer, William Gibson.  Hugo Award 1985, Nebula Award 1984.  Considered a foundational book in the cyberpunk genre.