Simply ordinary observations from an ordinary person - sometimes having to do with health care issues, sometimes not. Topics will change as my attention wanders. Yours probably will too....

Saturday, May 31, 2008

Book 'em Danno!

I love to read. Surgeons love to cut. Sometimes a surgeon loves to cut and also loves to write, which creates the perfect scenario for a med-surg-groupie-bookworm like me! In fact, I've read more than a few medical memoirs/narratives over the past few months, systematically depleting the inventory available from our tri-county library system - and even purchasing a few which weren't available at the library. (See list on the left!)

All of these books were enjoyable, but 3 are tied for my first place: "Bright Lights, Cold Steel", Dr. Michael Collins, "When the Air Hits Your Brain", Dr. Frank Vertosick, and "Cutting Remarks" Dr. Sidney Schwab. Fortunately this isn't American Idol, so I don't have to vote off two in order to write about one. I like each one for different reasons, but notice that each author is a surgeon - orthopedic surgeon, neuro surgeon, and general surgeon. 3 for 3 - that must mean surgeons are the best writers, which is probably what they think too! Just kidding...or not.

However, it's the general surgeon's book, "Cutting Remarks" which has prompted this post, for several reasons. First of all, Dr. Schwab is also a masterblogger and I visit his site more often than I'd like to admit. (But if my employer ever does a desk-by-desk computer investigation, I'm going to have a lot of 'splaining to do! Even tho HR work can be a pain in the butt, it doesn't really require knowing anything about colon resectioning. But that's not what I'm trying to write about!)

Secondly, the geography in this book is familiar. The other two books are based in Cleveland (or was it Cincinnati?) and the Mayo clinic, but I've never been to either place. Dr. Schwab writes about his time in San Francisco, at UCSF and SF General Hospital. I've driven by both of those many, many times and can picture both the white, shining complex on the hill and the imposing, solid compound on the flats. Although the buildings and the medical procedures have changed, the overall setting is the same and it was intriguing to read of places which I recognize.

Reasons three, four, five, and six will be lumped together in this paragraph. Otherwise,this post may end up longer than the actual book. Three: it's funny in unexpected places. Dr. Schwab's wit is as sharp as his scalpel and seems to be used just about as frequently. Four: it's educational. I now feel so proud of having a beautiful, robins-egg blue gallbladder that I need to take back rude comments I made about that organ in a previous post. Five: it's informative. For instance, my mental pronunciation of mediastinum was all wrong. It's not me-dee-ASS-tin-um as I thought, but me-dia-STY-num. Fortunately, the word hasn't come up yet in conversation so I haven't em-bear-ASS-ed myself. :-) Six: it's honest. While most of the books mention cadaver labs as part of medical training, "Cutting Remarks" is the only one I've read so far that acknowledges animal labs. It may be politically incorrect, but Dr. Schwab provides a realistic view of exactly how surgeons gain the skills they need before approaching a sick or injuried human. Don't be scared off - there are only 2 short mentions, but it was enough to make me aware that none of the other authors were brave enough to include it. Or, maybe it was insignificant to the others.

That leads me, finally, to seven. After I turned the last page I went out to garden, mulling over this piece of writing. My conclusion is that I now have a very good understanding of the difference between an occupation and a profession. And of the difference between someone who practices a profession and someone who IS that profession - Dr. Schwab removes his surgical mask and allows his readers into the inner core of a surgeon. He has the soul of a surgeon, not just head, hands, and heart. The nuns who taught me early in life would call it a vocation. Others might call it centered. I call it very fortunate for those who were his patients over the years.

Conclusion: Book highly recommended. Not to read it might be called a crime.

San Francisco has changed in many ways though, since the 1970's when Dr. Schwab trained there. A surgeon who cuts his finger to the bone while in a patients' abdomen today will be worried about much more than losing the case to another surgeon. It was strange to read this story, and realize that HIV/AIDS had not yet started its scorched earth run through the Bay Area. It was also a time before then Governor Ronald Reagan closed down the state mental hospitals, in a brilliant budget manuever - thereby releasing thousands of mentally ill to counties and cities ill equipped to treat them. The street corners of SF and the ER at SF General reflect the long-term repercussions of that decision, with a large population of homeless, substance abusing mentally ill and inadequate resources for treatment and/or housing. On the other hand, some things haven't changed in SF, as MUNI vs Pedestrian continues on a weekly basis!

Monday, May 26, 2008

Not Working Chair

During WWII, my father was helping the US Army build temporary air strips throughout the South Pacific, at war with Japan. He came home with a Japanese sword, a silk kimono, and malaria in his bloodstream. Sixty years later, his daughter is working for a small CA company which is owned by a large Japanese corporation and working side-by-side with grandchildren of the Japanese he was fighting against. We never speak of the war in our break room, especially not on Pearl Harbor Day or the days the bombs dropped on Hiroshima or Nagasaki.

When I entered high school, my oldest brother was US Marine Corps infantry, patrolling jungles outside Danang, Vietnam. He came home with fungal infections in his feet, unresolved anger towards his government, and an extra 100 years behind his 20 year old face. He never talks of the 12 months he spent there and, although I know a few details, I won't write of them here. Those are his stories and he chooses not to tell.

Forty years later, his sister gets bi-weekly pedicures at one of several Vietnamese nail salons in town. That's where I was on Saturday a.m., watching a young Vietnamese woman paint "Smell the Roses" pink across the tips of my toes. No fungal infection, no drops of blood following me out the door. There's no trace of the war here - these girls are young enough to have been born in the U.S. and I suspect most of them have never been to Vietnam.

In 12 months, one of my young nephews may leave for Afghanistan or Iraq, depending on where his National Guard unit is needed. It's difficult to imagine how this particular conflict will ever be resolved and I can't picture the types of U.S.-Iraqi partnerships which may or may not result. This war, to me, seems much more like the out-of commission pedi-spa I sat next to on Saturday. The one where a "Not Working Chair" sign was hanging.

Memorial Day, 2008

Saturday, May 24, 2008

Say Pretty Bird!

Seasons change very subtly in No. California and it's hard to know when to refill the bird feeders. Put them out too soon and the trays fill with rain water. Put out a suet bar during a hot spell like we had last week (102 in May?!) and the plants underneath are coated with Crisco. But I filled my feeders last week and already need more birdseed. As I was making out my Sat. a.m. shopping list I was watching the activity around the feeders and thought "maybe I'll only feed the finches and hummingbirds this year." In other words - let the sparrows, jays, & mockingbirds fend for themselves and only feed the pretty birds.

How wrong is that? Why are pretty people, I mean birds, worth more? Shouldn't the plain, ordinary people, I mean birds, be valued just as much? Why would I only want to attract pretty people, I mean birds, into my backyard? Why didn't I think, "maybe I'll only feed the sparrows and jays this year, instead of the finches?" Oh well, that's all too deep to think about on a nice Sat. a.m. I'm off to the store for finch food, sparrow food, hummingbird food, cat food, plant food, and then sharing some people food with my plain, ordinary, pretty friends!

Sunday, May 18, 2008

Bless Me Father

For I have sinned... I am a mean, untruthful person.

I was meandering thru the local Home & Garden show yesterday afternoon browsing unrealistic, expensive ideas for my humble little house when I stopped at an unusual looking display. The marketing posters promised "relief from asthma, allergies, and illnesses" and the shelves were lined with glowing yellowish pink rocks on lamp bases. Wow, I'd found a booth offering GENUINE HIMALAYAN SALT CRYSTAL SPELEOTHERAPY (caps not mine!) and the distributor gave me a full education on the miraculous benefits of owning one of these genuine rocks. (Um, hello Homeland Security? Have these pink, glowing rocks from Pakistan been searched as thoroughly as the lipstick and underwear in my suitcase last week? Just wondering.)

Here's the mean part - I was interested, but not because I believed in the product. I let the poor man think he might be actually making a sale, while my mental eyes were rolling around like Mad Eye Moody in Harry Potter V. My questions were answered enthusiastically, since he didn't know I was already compiling my blog post on the preposterous claims of this "most beneficial salt on this planet!" I admired the lamps, took the brochure, and laughed all the way to the car.

According to the brochure and salesman, the salt rocks emit negative ions to counteract the excessive amount of positive ions created by modern urban living. Apparently these positive ions "drain our mental and physical energy, suppress our immune systems, and affect our overall wellness." The Genuine Himalyan Salt Crystals can prevent all that and more! They will remove "dust, pollen, odors, pet dander, cigarette smoke, germs and bacteria." The salesman mentioned viruses too. And, they relieve "migraines, allergies, asthma, stress, fatigue" and most people "notice results immediately once immersed in an ionized area created by these salt crystals. Others may take a little longer depending upon their environmental sensitivities." I didn't ask about intellectual sensitivities. That seemed, well, a bit insensitive.

I met a friend for dinner and told the story. She said, "oh yeah, my neighbor Crazy Mona bought 3 at last years' show." OMG...the medium size was $85.00. But I guess that's cheaper than Prozac.

After reading the brochure tho, I realize I must have been bathed in negative ions during my 10 minute conversation since about 50 of the lamps were illuminated and emitting ions only 3 feet from where I was standing. Hey, come to think of it I felt pretty darn good today and still have enough energy to write this post at 8:30 p.m on Sunday night! They must work! Where's the order form? I need my own GENUINE HIMALAYAN SALT CRYSTAL LAMP!

Benefit Claims for Salt Lamps:
  • Natural air purifier
  • Alleviates symptoms of asthma
  • Provides relief from allergies
  • Reduces severity of migraines
  • Removes pollutants and dust
  • Removes bacteria and germs
  • Eliminates odors
  • Enhances immune system function
  • Increases lung capacity
  • Speeds healing of wounds
  • Reduces susceptibility to colds and flu
  • Increases alertness
  • Increases productivity & concentration
  • Increases energy level
  • Decreases nasal congestion
Note: The FDA has not evaluated these statements. No kidding.

Tuesday, May 13, 2008

HR: Helpful or Reproachful?

HR Office: Helpful, which means I get to keep my job:
Employee: Our health insurance sucks. I keep having to pay bills and I don't understand the paperwork.
HR: I understand - it's complicated and frustrating. Legally, I should not see your medical records but if you want to bring in the paperwork I can help you organize and double check the statements.
Employee: Brings in a 2" thick folder, with envelopes which have never been opened.

HR Office: Reproachful, a job search imight be in the future.
Employee: Our health insurance sucks.
HR: It's a new policy - did you review the insurance guidebook? Employee: No
HR: Have you set-up your password on the website? Employee: No
HR: Did you confirm that your doctor is in-network? Employee: No
HR: Have you attended any of the brown-bag training sessions? Employee: No
HR: Do you read the e-mails, memos, and employee newsletters? Employee: No
HR: Are you interested in the company wellness program? Employee: No
HR: Have you asked if a generic drug might be appropriate? Employee: No
HR: Have you taken advantage of the mail-in pharmacy program? Employee: No
HR: Are you willing to take any responsibility towards your health care? Employee: No
HR: Are you seeing any pattern here regarding the problem? Employee: No
HR: OK, then bring me your paperwork and I'll see what I can do.

Friday, May 9, 2008

1 + 1 = 18

“They didn’t know. My girls watch the calendar like a hawk. We just found out on Monday night.” Michelle Duggar, Arkansas, announcing that she's pregnant with her 18th child. O..M..G...

Apparently, Mrs. Duggar doesn't find it distasteful or unusual that her daughters monitor mom's menstrual cycles. Or perhaps they haven't reached the sex education module in their home schooling kits just yet, so the girls don't know the actual mechanics of what Mommy and Daddy have been doing upstairs in their 7,000 square foot house.

According to all the PR, this is one big, very big, happy family. But how can they all be healthy? Doesn't the female body start running out of nutrients to supply the developing baby at some point? Like around pregnancy #10 or #12 or #15? She must take mega-prenatal vitamins or maybe the Lord really does provide, over and over and over and over...ok, i won't type that 18 times. Since I inhabit a female body I know it's capable of some pretty amazing things, but come on - wouldn't the uterus start to get fatigued or rebellious after supplying enough children for 6 to 9 "normal" size families? Apparently not in this case. However, as you might be able to tell by now, I have one reaction to this story.....ICK!

Thursday, May 8, 2008

Cloud Gate, Chicago

The Art of Travel

Last week at this time I was packing bags for my first trip to Chicago, to attend an Edward Hopper exhibit at the Chicago Art Institute. The solitude, isolation, simplicity, and starkness of his images have always touched me and I decided it was worth a 4 hour flight to see a collection of his works. I was right - it was definitely worth the time and money.

Chicago's beauty and vibrant activity surprised me. I'm not sure what I expected, since changing planes at O'Hare was the closest I'd ever come to the city. But it was wonderful - full of spring tulips, spring tourists, spring showers, and spring energy. The weather changed every hour but that didn't seem to matter to anyone expect me, the West Coast Wimp unaccustomed to thundershowers, hail, humidity, or other variances from dry sunshine.

And, the city is full of art. Not just in the Art Institute but also in parks, in the business district, in public buildings, and in hotel rooms. Although the Hopper exhibit was the main reason for my trip, I encountered many more pieces over the course of 5 days. There are my 3 favorites, listed in order of size:

One: Cloud Gate: the astonishing polished stainless steel "bean" installed in Millennium Park just off Michigan Avenue. I visited the bean several times, at different times of the day, and never grew tired of it. It's brilliant in concept and in construction, and is obviously well loved by tourists and residents alike.

Two: The Edward Hopper painting which was hanging near the end of the exhibit, Sun in an Empty Room. It was a deceptively powerful piece - just a corner of a room with sunlight coming through an open window. He was 80 when he painted it, just 4 years before his death. Maybe old age will be like that - quiet, still, and uncluttered with time enough to just sit and watch sunlight move across a bare floor. Like many of his paintings, it also had a tinge of loneliness and isolation but I preferred to see it as comfortable solitude.

Three: The Chicago Cultural Center had a rather odd exhibit sponsored by the Orthopedic Surgeons Assoc. (or something close to that) with artwork done by patients and doctors. The pieces were interesting but mostly meaningful only to their creator (much like my blog!) and other than Miracle Manny, I really only remember one. It was a small photograph of a resident in scrubs, asleep somewhere within the depths of a generic hospital. It has been 'photo-shopped" to resemble an impressionist watercolor and was nicely composed and framed. But what was striking to me was the body mechanics of this obviously exhausted young man. When I take a nap on my couch, I put my feet up and snuggle up with a wrap and two cats. The resident was sitting - knees bent, feet flat, and upper body completely collapsed to the side. He was deeply asleep but ready for action at the same time. Although I doubt it was a conscious decision, it was a very efficient posture requiring minimal movement to get upright again when the beeper sounded. The photographer and subject would probably be surprised that I'm still thinking of the piece, but that's the purpose of art right?!