Monday, October 27, 2008

Fun With X-Rays




In an effort to get Etotheipi and Lofty (and you too Oldfart even though you have a good excuse) to quit hitting the bong and get back on the blog I'm posting this film to allow them to wax poetic about the diagnosis. Interestingly, the 'wow' part of this film is an 'incidentaloma', in other words, the abnormality on this film does not explain the patient's presenting complaint.

I did take this as an omen when I saw it however, as these thingies on the film all make a nice "O" shape and this, honestly, this was the first thing I thought of, drawing all sorts of allegorical connections about how they are representative of the accretions of doomed-to-fail socialist, anti-American crap espoused by the real life Invisible Man. Emotion over substance, concentrated, morbid, warmed over elitist, ivy-league, never worked a real job piss.

My first patient tonight also got me thinking. He is the archetypal pitiful, dependent male, who, at age sixty, can not answer any of my questions about his medical history, instead saying, honestly, "ask mama". Mama is mad at the hospital who saved his life because he's sick again.

He arrived here two weeks after his life was saved, at taxpayer expense, after he left my ER against medical advice with appendicitis. He ended up, a day later, septic and near death at the Mecca, and was there and in rehab for 45 days. The bill to the taxpayer? $300,000 roughly.

He has not been taking any of his medicine on his 'medson' list, and is very ill again.

Fine. There have always been people like him and always will be. The reason for me mentioning his case is not to poke fun at him... there's no fixing him unless I could put him in a time machine and enlist him in the Marines at age 18. But this is just the point at which I part company with the modern liberal.

The modern liberal, exemplified by the unsullied one, believes that government can make his life better. Yes, I am angry right now, and I'm angry not at my patient, but at my highly educated friends, many ivy-league graduates among them. They are the power behind what could be the most disastrous election since Carter, and they are children.

How else does one explain this... I exchanged emails with a friend the other day who admitted he was going to cast his vote for "O". His reason? "The free market is dead". Really? Who killed it?

This guy is the head of an academic department at one of America's best hospitals. He has degrees from one of the most prestigious academic institutions in America. He is smart and an incredibly skilled physician. How, in the name of all that is holy, can one believe this?

The answer is to either stand to benefit immediately from the thievery OR to ignore history, let your emotion rule your intellect, to have a deeply buried hate for the common folk (and the American warrior), AND to live within the doors of the academy (oh, and listen to NPR, love that idiot Keith Olberman, participate in candlelight vigils, and to trap all your farts in a jar to prevent global warming).

To those of you who know me, I'm sorry, I can not continue to have friendly chats with you... I'm not going to send you a 'festivus' card this year. I have wonderful friends, many of whom have put their lives on the line for the very Constitution that the glorious one thinks is "flawed" (which is certainly true as men wrote it), but the audacity to believe one has the 'fix' is megalomaniacal.

The unsullied one and the gaffe-machine commonly called Joe Biden utter Fighting words. I wonder if they are being heard?

52 comments:

  1. Hey look! It's Jack Skellington, just in time for Halloween!

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  2. 911 Doc,

    Does your employer have an EAP? You're off the reservation man. Way off. Like tinfoil hat off. Every day closer to the election brings more and more crazy shit from the peanut gallery on this blog and you. It's like the chorus of screams at the state hospital.

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  3. Nice X-Ray. You shouldn't leave those things sitting around your ER. You outta' bury-em!

    O' Great One, you answered your own question!

    You said that the O supporter guy was in Academics!

    As you know (but I'll explain for our readers), most Academic Docs are flaming libs because they practice within the bubble of academia. I exempt Old Fart and myself (many moons ago) from this general rule as we managed to keep our heads on straight whilst shaping young minds (scary, I know).

    About 50% of physicians are employed by medical schools or teaching hospitals. In most of these environs, the patients don't pay the physicians. The physicians are salaried and most of these institutions receive extensive governmental financial support (via Medicare under the umbrella of "medical education").

    Since the docs are salaried, they have little incentive to work too hard and therefore you'll find legions of docs on staff to do the same work that a few private practice docs will fight over. (Seriously, try and get a patient seen in one of these academic clinics...it's damn near impossible! But you can frequently find the staff gathered around the tables in the doctor's lounge sipping coffee and talking about the state of modern medicine and politics...No, I'm not kidding. (hey, Fart...remember the neurologist at our previous Ivory Tower who was FAMOUS for this?)

    I'm gonna generalize here, but these docs see medicine from afar, and from a totally different perspective. They don't bust their humps everyday seeing scores of patients. They don't worry about buying supplies, paying office staff, paying malpractice, filing out insurance claims, keeping up with new government regulations, paying insurance premiums for themselves and their office staff, investing and saving for retirement, etc....

    The practice of academic medicine is very different. I'm not saying it's easy. It's just different and the focus is shifted to teaching. You make less money, but many things are done for you.

    If you're out on your own like the other half of physicians and you're trying to make it as a small business, life is very different.

    When I read a medical article promoting UHC, or other socialist agenda written by a physician...I can almost guarantee that when I research the author, it's an academic physician! Widespread systemic changes won't affect them at all.

    I had an even more perplexing conversation with a good friend last week. He's a very bright and talented surgeon and also one of the most conservative guys I know. He informed me that he was voting for BHO! I was stunned.

    He explained that he felt completely abandoned by the conservative movement. He felt that the ideals that he had espoused and believed in had been made a mockery of over the past 8 years. As a protest, he said that he isn't going to vote for a conservative again until the movement "finds it's way" again (if ever).

    I tried to point out that I didn't disagree with his opinion, but I couldn't see how voting completely against one's convictions would help reverse the erosion of conservative principles. He had no answer for his.

    Sadly, I think too many folks in this election are voting AGAINST the Bush administration and AGAINST what they perceive as "corporate greed" rather than FOR the Democratic idea of "spreading the wealth around". Unfortunately, the results will be the same.

    P.S. I put tin foil 'round my head, but my opinion didn't change. Guess they were original thoughts and not the voices. Either that, or the anon is a piss-poor psychiatrist. Imagine that!

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  4. leave it to an anonymous lib to think that being on the reservation is a good thing.

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  5. Here come the anons with their DSM manuals. Quack quack quack.....

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  6. Hey 911, check my blog. I did some artwork with your picture. Hope you don't mind. It's for Halloween man.

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  7. It's just this type of patient clogging up the works at EDs across the country.
    What percentage of your patients do you recognize on sight? Know by name after just a glance? Few of which have anywhere close to the mental faculties required even to suspect that their care is anything other than magically "free." The same ones, as you say, who "hate this hospital," and are indignant at the long wait times, even though we've saved their lives and those of their family members and acquaintances over and over and over again, who demand free food and drink, "samples" of or prescriptions for widely available generic over-the-counter medications (which can be redeemed at pharmacies without payment if the recipient is on the welfare rolls), cable TV entertainment, long-distance phone calls, and footies, yes footies, all without the benefit of one cent of their own money as payment. To even attempt to discuss these issues with such a patient or their ilk is to be faced with either ignorance and stupidity OR maliciousness and avarice of a level I would imagine is not even conceived of by the average individual who might read this blog, were he not employed in medicine, social work, law-enforcement, or other similar "public service" sectors.

    What liberals, and even a frightening number of so-called conservatives just CANNOT GET THROUGH THEIR THICK SKULLS is not just that PEOPLE OF THIS NATURE DO NOT HAVE EVEN THE CAPACITY TO BE HELPED no matter what insane level of resources are confiscated on their behalf, but more importantly that THE PROPER ROLE OF OUR GOVERNMENT HAS NEVER BEEN NOR SHOULD EVER BE TO DO SO. If you disagree, as an assignment, go find such a role outlined in the US Constitution and report back. If you disagree on the former point, volunteer to shadow a full-time ER doctor or EMT/paramedic on a daily basis for at least a full month and report back.

    Despite these facts, angry and dismayed reader, we, our nation's most expert yet most exploited providers of healthcare to the needy, can and would be willing to provide CHARITY care for those with TRUE EMERGENCIES, though we SHOULD NEVER SUFFER SILENTLY about being FORCED to provide care that CONFISCATES our very lives -- our years of hard work, dedication, and costly investment in ourselves, all while we are subject to the risk of personal financial, emotional, and professional ruin through our malpractice system, commonly at the hands of an individual who fails to compensate us for the care they demand from us on a monthy, weekly, and yes, even sometimes daily basis.

    So, anonymous, if the upcoming election, which seems destined to bring to power a radical president and strengthen a majority party in Congress whose policies would exacerbate these problems, not just for ER physicians but for the country as a whole, all while confiscating even more of our income through taxation, as if we had no just claim to the fruits of our labors while those who exploit us daily do, whips us up into a frenzy of words, we hope you'll understand. If not, go fuck yourself with a big fat 14" dildo paid for by your tax credit.

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  8. Wow Amy, I went to Gastronomy Girl blog first, and I thought that Mochi was the artistic representation of what was up that old Dad's stinker (probably not too far off). Once I found the 911 pirated pic, I LMAO.

    But still, don't eat that Mochi stuff...especially the one with the stick in it.

    Anybody got a Guaiac card?

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  9. Tamponade, they'll never get it because they have never been there. They look in from the outside, watch a few medical dramas on TV, look up a few diagnoses on WebMD, and suddenly they're "experts" at what we do and how we do it.

    If we point out the constant abuse of the ER or the unsavory characters that we deal with over and over and over again...these so called "experts" will get on the blog and call us heartless.

    Before they head off to their shifts at the 7-11 (which they worked so hard to obtain by going to night school to earn their GED), they'll anonymously blog that we are too rich and need to be taken down a peg or two.

    They don't care about what REALLY goes on. They just want to sound smart by using words like "body politic". These are the "fungus gnats" of the blogosphere. They buzz around your face but are essentially inconsequential and usually easily ignored.

    So here's a good one for ya: in the last hospital where I worked, we had an entire extended family who used the ER for every little thing. When one registered, about 10 other family members would register (this happened about twice a month). Not once would any of them use their PCP (though they were all funded through Medicaid which would not pay the us for the non-emergency care).

    One night when the whole family presented for their variety of feeble freebie BS complaints, the 1/2 of the family that didn't check in to be seen was found carrying the furniture from the ICU waiting room down the back stairs and loading it into their pick up trucks!

    These are the "bottom up" people through which BHO is gonna grow the economy! May God have mercy upon us (and the fungus gnats)!

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  10. A few random thoughts at 0645 before heading to orientation at my my job where, as opposed to being a competent nurse, I will learn how to "respect all cultures" and "not to sexually harass anyone"

    The academic MD comment was right on. I will never forget while working at a county inner city ED hearing an Attending telling his medical student to "order any test you want...the taxpayers will pay for everything" When I humorously confronted him, I was informed "that anyone who doesn't support universal healthcare has no business being in medicine"....self riotous smug asshole...he was always the first to scurry down the hall AWAY from the nurses when we were being abused by patients.

    Also....have you guys heard the 2001 radio interview with Obama that has just surfaced with him criticizing the Supreme Court from not pursuing "wealth redistribution" during varioius "civil rights" decions...very very telling....and very very scary. McCain just needs to run that interview on a repetitive loop during Obama's socialist 30 minute informercial scheduled for Friday night.

    Also starting my day seeing red. I am a rabid English soccer fan (go Manchester United) and am on various different blogs with mainly Europeans. I actually argued last night with well-educated people that stated there is "no difference between the Founding Fathers and Islamic terrorists......that Thomas Jefferson is the moral equivalent of Bin Laden"...the whole moral relativist bullshit argument that "one man's terrorist is another man's freedom fighter" blah blah blah. This is main stream thought...several Americans even jumped into to agree.

    WHAT THE FUCK....is all I can really say.

    Keep being angry...the problem is that most of us are not angry enough......

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  11. So...dudes...what the hell does the X-ray show?

    Are those alien cysts?

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  12. Could be some kind of radioactive doo-hickies for bladder cancer, or maybe they're just marbles. Looks like a Clearie and a Jew-ball.

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  13. Hey, academic hospitals also never move fast enough on the business side of things. (As many of you know I'm a recruiter)

    How many meetings do you need to have once you know you want to hire someone!?

    AGGGGGGG.

    Also, my job will get plenty more interesting if UHC comes about... will places still be able to afford locums? Will they have a fund to pay for perm placement?

    If they don't, do they really think they'll be able to attract competent physicians to some of these "geographically challenging" places?

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  14. I read the whole thing, and never found out how Obama gave this guy bladder stones. I assume that these are due to his previous appendix issues and medical non-compliance? Or, is he just unable to take care of basic needs, such as drinking and voiding without Momma to tell him to?

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  15. As the election gets closer, I feel like Charlton Heston ... "You blew it up. Damn you, damn you all to hell."

    "Feed the men, then ask of them virtue."

    "In the end they will lay their freedom at our feet and say to us'Make us your slaves,but feed us."

    Dosteovsky-Grand Inquisitor

    It is amazing what some people will throw away for a few "scraps" that BHO and his boy Robin will throw at them, $1000 here, food stamps there, a baby bond here.
    Listen, all you BHO jerkoffs, my friends and I that pay the bills are on a one way train to Galt's Gulch (i.e. the caymans or some other sanctuary to keep any and all money out of their hands) and there will be no one left to buy your shit and pay for the pork. So why don't you learn how to fish instead of just eatin' the govt's cod.

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  16. Matt, I don't presume to speak for erdoc85, but I think it's more of a nifty eye-grabbing photo that provides a segue into his discussion. AFAIK, those thingies aren't related to his retarded saga of leaving AMA with appendicitis then showing up dog-sick and near death at another hospital, just to be bailed out (again) and in so doing destroying the equivalent of the productive yearly output of about 6 average US families in one go. Yeah, our model of a "right" to healthcare is sustainable. Sure. Just give it a few more years of hospital closings, physicians cutting back their practices or outright refusing to provide EMTALA-related care, take Medicare/Medicaid patients, and so on. Many of us will become electricians or plumbers instead, or move to Costa Rica or some other non-redistributive nation and set up our practices there.

    Jennifer, your comments regarding academic physicians are spot-on. These are the same folk who pretend to represent us in our professional organizations, taking positions completely opposite what the majority of full-time clinical physicians would support. Such as the new continuous certification model, which requires yearly testing, being clinically observed, and participating in other ridiculous and meaningless seminars and such, all at great individual expense. Or promoting the view that everyone has a "right" (gee, there's that word again) to access to "excellent emergency care." Uh, if you create some bogus "right," that only guarantees that the care will rapidly deteriorate below the level of excellent compared with what is possible when the care is a privilege that is paid for. If you doubt this, check out the level of service available at any of a number of "free-standing" ERs blossoming around the country. Good work guys, keep it up, and keep indoctrinating our students and residents with your morally bankrupt ideas. Thankfully it takes only about 3 months of real-world experience for those viewpoints to be dispelled by the harsh truth of the matter.

    On a lighter note, go Red Devils! They haven't had the best start to the season, and though I'm a bit worried, I'm by no means counting them out. It's great to see another football fan that doesn't have a bleeding heart.

    Which brings me to our European counterparts... anyone find it ironic that a large number of our ancestors fled the oppressive systems of the old world to found a country on individual rights and liberty, only to produce descendants who have moved that country steadily back in the direction of the now socialist nanny-states of grand old Europe? What say, anyone who thinks the founding fathers and the Constitution morally bankrupt or equivalent to Bin Laden gets a free one way ticket. We could pay for half the US population to have even a luxury cabin or first class ticket for a fraction of the cost of the financial "bailout." And we'd actually see something productive from our investment. I'm sure our European friends will be happy to absorb their kind hearts or freeloading asses into their grand welfare states, all without complaining one bit, even as they actively seek to destroy their economies and their social and cultural fabric.

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  17. 8 little baby IUDs?

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  18. Vesical calculi ?

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  19. I think it's pirate's loot. Those chocolate wrapped coins from China with the melamine in them. Your booty might be a good place to hide your ummm...booty?

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  20. I'm thinking maybe instead of my current plan to move to a less expensive house in order to feel more financially comfortable because of all my medical bills maybe I should just go to the ER and take care of it all. It would be free, right? Screw personal responsibility. I want free stuff.

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  21. Jennifer, BHO won't have a 30 minute infomercial about his socialist "spread the wealth" agenda. He knows better than that.

    Instead, he'll have a Halloween special where he'll wears a mask of the everyday middle class American and try to convince you that only evil millionaires who don't really work for a living will feel the impact of his policies.

    Then he'll remind you that huge government is a wonderful and benevolent institution. Finally, he'll PROMISE you that if you make under $250,000 a year, or own any one of 95% of small businesses...as soon as he's announced the winner of the election your pockets will bulge with redistributed
    cash and butterflies will fly out of your butt.

    Sadly, I don't think people care about his socialist radio interview from 2001. You've seen these people's comments on here. Most of them aren't FOR BHO's policies. They want to "stick it to Wall Street", and everyone who in their mind is "rich". They rightly conclude that BHO is the best way to do that. Unfortunately they haven't thought too far ahead.

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  22. Not my issue. I seem to remember part of the Hippocratic Oath says, "I will not cut for stone, even for patients in whom the disease is manifest."

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  23. I like to do fun crafts with my fart jars and put them on display in my home.

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  24. I heard on the radio this afternoon that BHO had raised between $600 and 700 million as of September! I heard him on the radio last week begging for money to "combat the enormous McCain financial machine".

    Based on the money reported in his pot at the end of September, his campaign could spend over $12 million a day until the election!

    Hell, he could have single handedly bailed out the US economy.

    I seem to remember the charges every year that the Republicans always bought the elections. Funny, but I haven't heard that complaint once this election cycle.

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  25. As a current medical student, I can tell you first hand that the libs predominate here in the academic world. The only thing worse than a regular academic doc are the public health guys. The public health textbook was basically a smear of the 8 years of Bush and how the world could be saved if our nation just bought fewer guns and hugged more terrorists. Every time we had a lecture by those guys I kept thinking "Im working way too hard for this degree to go into public health". How does that happen anyway? I suppose it is just for those people that get far enough along in the process and realize that they are afraid to touch patients and owe too much to back out now.

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  26. Milsurg - As far as I'm concerned there won't be enough guns in this country until Saturday night specials and single-shot shotguns are begging people on the street to take them home.

    When I got my CCW permit, the Sheriff said, "That's what we need - more armed law-abiding citizens."

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  27. "Hell, he could have single handedly bailed out the US economy."

    I might vote for him if he donated all his funds to solving the national debt. Brilliant idea!

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  28. Holy crap! I have been scared about what this country is going to become should "O" get elected - and absolutely terrified now that I've read your blog! I was just nervous about how everything will ok to do - baby porn, child rape, abortions of every kind, legalization of all illicit drugs, etc. - but now reading about all this "health care reform" and wealth redistribution, I'm ready to move to another country. The really scary part of this is - my entire extended family is ready to move too. My husband's extended family thinks "O" is the savior of the world - but then they think Tom Cruise is smart too - so there you go.

    My best friend was an accountant for UT-SW Med. Ctr. and she still talks about how liberal all the docs were there and how they made the Hollywood libs look tame - just because they wanted more grant money. With "O" that can only be the death-knell for this country. God help us all!

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  29. I just have to say that I really enjoy your blog. You all do very well and I laugh everytime I come here. Your blog has become one of my favorite stops.
    With that, I have to tell you that I have not been able to stand to read the content for several months now. I will not be back to read your blog again until after the election is over. I am disappointed with the discourse and can only hope for the day when the wit and humor return to the blog.
    Thank you, Doctors, for the laughs in the past and here's to a future free of this puerile banter.

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  30. dear sandy,

    so sad to see you go. in the meantime i feel compelled to point one thing out to you. before the recent string of political posts we were nothing if not puerile. 'puerile' means childish.

    so, to summarize, i think the political posts have been anything but puerile. hell, i even referenced a book that no one would have read if they hadn't been forced to in school AND talked about the US Constitution!

    here's a puerile riff on your name...

    sandy bottoms
    sandy cheeks
    sandy chafer
    sandy lipschitz
    sandy candee
    sandy urethra
    sandy vagina
    sandy johnson
    sandy pubes
    sandy mcmandy
    sandy sandy bobandy bananna fanna fo fandy me mi mo mandy SANDY!

    CYA

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  31. I'm really unsure of how your post was to upset me.
    Yes, you have eloquently demonstrated your understanding of my vocabulary.
    I'm glad to see your passing reference to the Constitution, though the link to Obama's denouncement leaves much to the imagination.
    I'm sorry to hear that you were forced to read literature in school; luckily, I teach English at an impoverished public school and thus, am unlikely to punish your children in a similar manner. I'm sure you will be able to provide for a better learning environment.
    I merely wanted to inform you of my previous enjoyment of your site and my recent disappointment.
    I can see that you have fully accepted the decline and are relishing in it. Congratulations.
    I am content in knowing that however the election may culminate, you, at least, will have plenty to commiserate about with your fellows.
    Best wishes,

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  32. Sandy, I congratulate you on a well constructed treatise (guess the English teacher thing explains it). I diagrammed all of your sentences and again, you did a superb job. Kudos!

    I am disappointed that you don't find our purile election banter as stimulating as our pedantic medical banter.

    Never fear. We won't grow up anytime soon. One caveat however; after the election, we just might still have political opinions.

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  33. This is rich!

    My sister teaches at a fairly exclusive private school. Today, the Senior High Debate Club staged a debate between their Pro-Obama and their Pro-McCain members. I went to see what the arguments and perspectives might be.

    Being a well to do school, and being in Texas, most of the students were McCain supporters. But there were enough trial lawyer kids and non-WASP kids to make a decent Pro-Obama showing.

    Overall, the arguments were the same old crap that you have heard a thousand times from both sides.

    Toward the end of the debate though, the McCain kids accused the Obama kids of being in favor of Socialism. Rather than become upset at this moniker, these kids responded by saying: "so what is so wrong with Socialism? Lots of things in our society are Socialist and they work just great; like the police department, the fire department, the EMS, and the public schools"!

    My sister had to grab me to keep me in my chair. Not withstanding the fact that police and fire are governmental services and not Socialist endeavors, and not to mention that EMS systems are either like the fire department or are run as not for profit entities.....

    Never mind all of that. I wanted to stand up and scream that these kids had the nerve to praise how well the public school system worked when their parents put them in private school!!

    Unfortunately, none of their McCain debaters had a clue what to say in response.

    Oh to be young and clueless again!

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  34. Notice how those who disagree with the main political sentiments on this blog either make insults, pick up their bags and go, or both?

    The closest I have seen to making a counterargument is giving examples of "unfortunate" individuals desperately in need of more government help, or making the argument that "you knew what you were getting into therefore you cannot complain," which must mean everyone must not seek to promote what they know as right or improve their own personal circumstances if they voluntarily entered into any non-perfect situation or arrangement, which of course is every single one.

    There is no one I have read even attempting to make the argument "Well, you see, redistributive policies are good and this is why..." OR "EMTALA was the best thing to happen to American medicine EVER!" The reason? Our positions on these issues are essentially unassailable from any sane, rational, moral point of view, and even the BO fanclub types know it. Their only resort is to cover their ears and ignore reality.

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  35. Amen WF!

    It's as if our opinions about medicine, politics and government interference in our personal and professional lives, EMTALA, system abusing patients, resource abusing patients, etc hadn't been a frequent themes of this blog for as long as I've been a contributer and reader.

    All of a sudden there are people who have "always enjoyed the blog until recently". Either they haven't been paying attention or they haven't been reading very long at all.

    You hit the nail on the head. Not one has made a coherent argument FOR the BHO policies.

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  36. dear erdoc85,
    logic is dead. they emote more convincingly than we do therefore we lose.

    i was also thinking that a 'spread the wealth' option could, by close analogy, work well for me.

    i need to lose thirty pounds and i would like to give them to people who are too thin. another way to look at this is that some people are too skinny and that this is unfair.

    the plastics guys will love this. i'm sure there will be a whole new branch of medicine that springs up to deal with, what i assume will be, a graft versus host epidemic, as the adipose transfers are started in earnest.

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  37. I'm so sorry Sandy can't handle honest feelings and opinions here. Aren't doctors and nurses supposed to have them? I am a grandmother who unfortunately became disabled at the age of 34. I have been living on Social Security since then and it has been a struggle. Keeping that in mind, I would never, EVER, want a doctor or any other professional to have to give up anything more than they already have. Obama would destroy this country with his socialist ideas and plans. I hate being on a fixed income, hate having to use Medicare, and hate that my independence has been curtailed. Too bad more people don't feel that way. You guys work too hard to put up with this crap. I used to work at a government hospital, and I was paid crap, even though our department of five people served more than 12,000 veterans a year. Medical personnel deserve much more than they get. I give it myself if I could.

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  38. dear denise,
    thanks for your support. i don't know too many people who would not like to make more money, but i think i speak for all here when i say that we would rather be freed from super-regulation and micro-managment at our jobs. combine this with requiring an ounce of responsibility from our patients and we are happy.

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  39. Denise. God love you. You get it, and I wouldn't expect a thing more from you. You're one of the ones that I'm happy to help regardless of reimbursement because you understand and appreciate what we do. A simple acknowlegment goes a long, long way. Thank you.

    911, there's a wealth distribution analogy that's been floating around lately that you've probably seen, but I'll repeat it in case any "long time" readers who have just discovered a political message on the blog haven't heard it.

    A guy goes into a restaurant and has a nice meal. The waiter who is trying to save money for college is working hard to keep up with all of his tables and give good service, and by all accounts does an excellent job.

    At the conclusion of the meal, the diner leaves a note for the waiter telling him that he appreciates the service and will be donating the tip to the homeless man out front since he "needs the money more".

    At the receipt of his "free" money, the homeless man, heads off to buy a bottle of cheap wine (or two). The college student witnessed the episode and was furious that the money that he had worked for had been given away to someone who had not earned it.

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  40. I have some extra abdominal skin left over after gestating children. I am currently searching for a place to make a living donation. Surely somebody's gotta want my perfectly good escess skin. I *know* it's nicer than cadaver skin.

    Maybe BHO will set up a government agency that will help me redsitribute my excess skin to those who need it more than I.

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  41. Amy - since most humans have two eyes, two kidneys and two lungs and can lead pretty reasonable lives with only one of each, I envision a boom in organ transplants when Obambi is elected. After all isn't forced organ donation a natural extension of sharing the wealth?

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  42. Maybe you guys can answer this. I just voted - took almost 2 hours for "early voting". 1 polling place for 150,000 people - brilliant - but that's IL for ya.

    Anyway, as we were standing in line, a late 30's-early 40's man came out of the polls, walked into the hallway and started cackling like a nutcase and then yelled "I have NO CLUE where I am - but I just voted!! How do I get out of here?!". My husband and I immediately recognized that all his marbles were not in place. This man then was recognized by someone in line and they struck up a conversation - something to the effect of this:

    Friend in line: "So how are you doing?"
    Voter: "Good! I just voted - but I don't remember for who? Isn't that funny?!"
    Friend: "Uh, yeah. So are you in school?"
    Voter: "Yeah, I'm at Jack and Jill Daycare right now. But most recently I was at ___ elementary school, but they made me go back to Pre-K........." and on it went.

    Question: I thought only those with their full mental faculties were allowed to vote. Am I wrong or is it just because it's IL? This guy had no clue who he just voted for and I can tell you that the 90+ YO male in front of me (who btw, had a LOT of excess gas! Good GRACIOUS we needed gas masks!)also had no grip on reality and kept telling the person with him that they were a stranger and needed to leave him alone. Of course, the stranger was his son.
    So, is it legal for these people to be voting? And if so, what the HECK?!

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  43. The one problem I see with all of this is that presidents don't actually pass legislation. I get that both guys are promising crazy things on both sides of the aisle, but I doubt that we'll ever see much of that in legislation. So maybe that's a good thing.

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  44. I must say that I disagree with a great deal of the political musings on this blog.

    I agree that doctors are getting screwed, and healthcare regulation is fucked up.

    That being said....I think healthcare providers in the ER are faced with the scum of society everyday. When you give stuff away for free, that is what happens. I really think a $25 charge for the ER would change the world of healthcare.

    But anyways... As a Social worker working on the acute rehab floor of the regional trauma center, I have another prespective as well. Hard woking Joe is walking down the street...drunk driver mows himover. Now he is a T-4 Asia A. He iswell insured, but....his bc/bs ends cause he lost his job. I am glad we live in a country that will provide him medicaid. Does that make me a socialist?

    As far as the welfare gravy train you like to talk about. Seems to me it is cheaper to throw money at them in the form of TANF and food stamps, and housing. Then the cost to educate, training, or keep them locked-up. Do the math, and tell me who the fiscal conservative is....

    That being said, I believe in honoring hard work. I believe that hard work can be seen in the physician, but as well as in a member of the housekeeping staff. Do I think doctors should get more money? You betcha! But do I think that housekeeper should be able to afford hosuing, food, and Healthcare? YES! Does that make me a socialist?

    All in all. The most important thing in this election to me...as it stands..Is Sarah Palin. She is as cute as bunnyrabbit! That Maverick McCain has some bad life-insurance statistics going on. I cannot in my heart, let Palin be president. That, in my eyes, would be a huge security risk. She is a little too wet behind the ears.

    Wasn't Palin in cohoots with some Alaskan secessionists? That is so American of her.

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  45. dear ladyk73,
    with respect, i think your heart is in the right place but your information is wrong. it is probably wrong because you get all your news like you used to get all your news, by reading your paper or watching the nightly news.

    one rhetorical trick the democrats have been able to pull off is to paint conservatives as AGAINST a fair shot for everyone. this is a lie. we merely disagree with how to do this.

    barely hidden in your comment is a very elitist theme, that there is a class in our society that can not do anything for themselves so should be made fully comfortable by taxation and redistribution.

    conservatives think better of people and believe that a hand out is never a hand up.

    also, your information on sarah palin is wrong. she has had more foreing policy experience than obama, being governor of alaska and bordering on the former USSR she has commanded the alaska national guard during her tenure and has stood up to and defeated corruption within her own party.

    obama, on the other hand, wants to sit at the table with kim jong il, that maniac in iran, and chavez.

    i think it is interesting that hillary was never given this sort of scrutiny and neither is obama. he, in fact, is the one 'wet behind the ears' and biden, is, in fact, the one who has come out and admitted that within the first six months of an obama presidency that we would face an 'international crisis' to 'test' obama.

    speaking personally, this scares the shit out of me because i do not believe, like many liberals, that being 'nice' to rogue nations will do anything other than embolden them, and history backs me up with germany in WWII, Korea, Vietnam and the millions killed in Cambodia after we quit, the Carter presidency's muffed and fatal hostage rescue attempt, Clinton's pull-out (pun intended) from Somalia, the first bombing of the WTC, the USS Cole, the Khobar towers bombing, Bosnia-Kosovo, and the culmination of perceived weakness, 9/11.

    if you were a terrorist, who would you prefer in the presidency?

    best.

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  46. I've been hearing the pollsters say that people who think are voting for Obama, and here you are offering up anecdotal proof.

    Interesting, eh?

    Little scared are we?

    Things really will not change THAT much. Haven't you figured this out by now? Really, the only big changes will be the dramatically reduced national debt and deficits. Have you followed things at all in your lifetime? It always takes a democrat to come in and clean up the budget after the republicans have mismanaged our tax dollars and somehow reduced our nation's profitability. Perhaps its the constant cloud of doom hanging over our heads whenever a Republican is in the house...who knows. I just know...the sun will be shining tomorrow and the bills will start to get paid at long last and a few people who've been explaining to their kids for months now why they can only have milk SOME of the time will finally be able to provide the necessities on a daily basis once again.

    Of course, small minded people can't seem to step outside of their happy place long enough to realize that most of the rest of their world's population is NOT HAPPY with the status quo and absolutely does not want it to continue. Whether it be health care, economic hardship, or....eh-ehm, emtala.

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  47. dear cannedam,

    you are not only unreasonable and illogical, but you have no knowledge of history.

    i really do encourage you to keep posting here because if i told people about you they wouldn't believe me... to wit...

    "i hear the pollsters say that people who think are voting for obama" by which you mean to say that smart people are voting for obama.

    if you could actually process what we are saying here we agree! there are a whole bunch of 'smart' people voting for obama who are protected within the walls of academia (that means they are in colleges and universities and need not fear for their jobs or their paychecks because they have this thing called 'tenure' which is kind of like a 'monopoly' but now i'm giving you a whole bunch of words to look up in the dictionary so i'll stop).

    also, if you are 'hearing pollsters' then you may want to check yourself in to the nearest hospital as auditory hallucinations are usually diagnostic of schizophrenia.

    but more to the point, 'people who think' certainly are voting for obama as i do not know anyone who can actually vote who does not think. "people who think" are therefore also voting for mccain! wow.

    in the very next sentence you make a bit of a gaffe. there is no such thing as 'anecdotal proof', if there were, it would no longer be anecdotal, but merely true.

    and yes, we are scared, because people who 'think' just like you might soon be in power.

    but as for your hope for revenge on folks like us, you know, folks who have kept you from acheiving and kept you down, there will be none as the sad result of redistribution, every time, everywhere is merely a numbed state of mediocrity, so you got that going for you, which is nice.

    our money, and more importantly, our skills, will vanish. raise taxes? okay, i'll make less. want me to work for free? i already do with over 50% of my patients. as a matter of fact i'm taking care of a very sick patient right now so i do have to keep this short.

    not to put too fine a point on it, but there is an election today. if obama wins fine. if he doesn't, please do come by and regale us with all your conspiracy theories.

    i'm sending you a secret message during 'the view' tomorrow. have pencil and paper ready.

    ps. what is 'small minded'? if i am small minded, and this is, as you seem to imply, a bad thing, this must make you 'large minded' and really smart. i see from your 'about me' post on your blog that you are trying to save the planet. good for you! say hello to God for me and tell him i'm trying my best.

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  48. I don't hope for revenge. I have no need or reason for revenge. Not sure where that's coming from. I just find it laughable that people of a rather comfortable income bracket -- one that doesn't involve juggling to provide necessities at any time except when personal irresponsibility has come into play -- can complain about a lousy 2% tax increase. Something that really won't affect their standard of living or quality of life.

    Just to be clear on things, I do think that doctors deserve even better than a living wage. I don't think that doctors are the problem with health care in the states. I think it has to do more with administrators, insurance, and horrendous high costs of insurance, inflated costs to drive up profits, and the ease of acquiring a 'disability' determination in order to qualify for either medicaid or medicare (though doctors are involved in that qualification.) I don't believe that addicts and alcoholics should qualify for disability because of their illnesses. I don't believe that high functioning bipolar people should qualify for disability. Maybe that puts me a little closer to your line of thought. However, I KNOW the realities of insurance availability and affordability. When an employer does not offer health care coverage and it costs the equivalent of a low income salary to insure a family, personal responsibility isn't the culprit. When a hospital tells a person they want the insurance copay up front before they'll perform a necessary operation, something beyond personal responsibility is at play. Things just aren't so black and white as you on the far right would have so many believe.

    I know you are in the unlucky situation to be able to see the dregs of society who are draining our reserves, but they are by no means the rule. And I can't help but feel that they deserve the same quality of care you would give to the person insured to the nines who would never have a fear that the hospital will find a way to street them because they're a medicaid patient.

    I know, again, you'll say personal responsibility -- go earn more, go work for a company that offers insurance. For many that simply isn't an option. Really, what would happen if all those in the low-income brackets were suddenly capable and available to move into higher earning jobs. Who would be changing our parents' diapers, scrubbing the toilets, disinfecting the surfaces on which we eat or shit? What would happen? We need those people as much as we need you. And somehow, I cannot see my way clear to denying them the same insurance that you or I have enjoyed. Why do they not deserve it?

    I'm not sure what The View comment alludes to as I've never watched it. Maybe I'm missing something, but I doubt it.

    I'm also unclear on how my unwillingness to further pollute the earth, my children, and our food with chemicals and other garbage has to do with god. (And no I'm not one of those idiots who eschew immunizations based on irrational fear or anything else. My children are all immunized.) I don't do the god thing, though that might seem unlikely for some reason I can't fathom. The earth's problems are people created and I and others like me simply refuse to perpetuate those problems. Unclear on how that makes me somehow lesser than you, though that's your tone.

    Small minded is simply the inability to see beyond your own situation to the realities of so many others. The narrow view of the extreme right cannot be accurate simply because of its severely restricted scope.

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  49. So, what are the little round things? Someone said bladder stones ... that sounds unpleasant! What does diverticular disease look like on film? I hope that's not a petrified turd!

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  50. they are bladder stones. the cure is seen in the movie "the green mile".

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  51. Just thinking about that makes me cringe.

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