Sunday, July 10, 2011

Of U2, the ER, and American Medicine

Now I don't think Hank ever done it this way, but wow! I mean THAT's a stage. It dwarfed Vanderbilt's 'stadium' and the concert drew as many fans as the Vandy football team does in two seasons. Huge. Epic. And to be fair, U2 was up to the task. Bono, probably because it is verboten to call the Emperor, I mean Obama (yup, that's for you Frank) "naked", soft-pedalled the 8th grade political grandstanding and he and the band were tight and played the hits and some more and the show was fantastic.

So this show sold out in two or three hours back in October and to get a primo seat was $250 and to sit on the grass was 75$ and *boom*... all the seats are gone. But because of my incredible position of prominence within academic medicine I was given first dibs on tickets and I bought four at $250 and figured to double my money as I don't need to see U2, but I could sure use an easy grand right? I mean I'm paying cash up front and I got great seats and I figured that U2 in Music City was a no lose, lead-pipe cinch for some easy cash... certainly a better investment than anything on Wall Street... still with me?

Well, I did not know about the flaw. I should have figured something was amiss when I could not sell the tickets when I bought them for more than face value, but I held them for the frenzy around the show to drive the prices back up.

And to cut to the chase, on the day of the show, early, I found myself making a trip to Nashville to stand on the corner and sell tickets. I did sell them. I met some great Americans doing it, and I lost my ass. But, having discovered that getting pissed about things beyond my control is only fun if I have an audience, I decided that I would go ahead and see the show.

Now these are not the best seats in the house, and this is a terrible picture, but the giant, 360 degree HDTV screens above the stage made for every seat being a great seat. Even this one (it's the same picture as above only after sunset and with the strobes etc..) And the sound. Wow. Awesome show.

But there is one thing I am not telling you about these seats... They were free. And, as it turns out, the reason I could not sell my tickets for what I paid for them. Because these seats were in the parking deck overlooking the football field. The drinks at the Marriot were cheap, compared to the drinks inside the stadium. I would walk around the deck, watch the show for a bit, get a drink, a little bit to eat, and it cost me about thirty bucks (after losing my ass on the tickets). Turned a pile of shit into fertilizer. Nice. And then I took some more pictures.

These seats were free too... Closer to the stage, in fact, than the rear-most general admission seats (the $75 seats). Now you couldn't see the stage from here, but you could hear everything loud and clear and the high-def screen made it so you could count Bono's nose hairs.

So what? Well, in my wanderings around the parking deck checking in on the band and people watching I saw this, and yes, it's a terrible picture, but hell, it's a cell phone...

That's Vanderbilt Hospital. If you are dying and you can get there you will probably live. If you have any number of bizzare illnesses that would kill you if you lived in just just about any other country in the world you have hope if you can make it here. Their children's hospital is also world class. Vanderbilt Medical Center is in a league with Emory, UCLA, Harvard, and John's Hopkins. It is a Mecca.

But part of the deal used to be that, for the most part, if you were admitted to Vanderbilt or were seen in their ER you had to pay... something, at least, for the care delivered. You still do of course, if you have insurance or money or a job or a car or a house. But if you have none of these things, or only a few, or are in the country illegally you can STILL get in here and get access to the $250 dollar seats. And here is where you do it....

Now U2 isn't hurting and neither is Vanderbilt. U2 makes a ton of money because people will buy $250 dollar tickets AND because most stadiums will not allow the freebie seats. Vandy is not hurting because it simply overcharges people with insurance or money or assets to pay for those who don't. Why is your medical insurance so high? Because the west end of the end zone is wide open, and it's free. In NYC it's called  three-card monty and you guys are all suckers.But the difference is, Vanderbilt Medical Center, like all hospitals in the country, can not close it's end zone. EMTALA. and all. The effect is to be punished for being excellent. It's going to be hard to watch our great institutions die, but I guess it is necessary to make things fair. *sigh*


  1. Hey, I thought you were going to tell us about the 'best health care system in the world'? You never mentioned Switzerland or France once.

  2. Been learning a lot about world health systems the past few days...very eye opening. its taken away my emtala do-goodedness--we have to do it better, or we'll devolve into what I'm seeing abroad.


  3. dear anon 1,
    i believe you are correct about Switzerland and France has some fantastic docs. of course Switzerland actually kicks illegal immigrants out and doesn't give them heart bypass surgery for free so i think they are a good bet to continue to be excellent. and France? really? didn't know that. i mean there is that one hospital there that is so famous... the one that pioneered... uh.... that thing.... but the name escapes me.

  4. Alright 911, I finally get a chance to E-Pimp you before I post this:

    70 y/o/f, c/o diffuse abdominal pain. Coming up to me she had some major trouble walking. She took a seat, and she had a very obvious lesion around her neck, dermatitis on her hands, and a fissured tongue.

    No googling.


  5. MS1: don't wanta sound like an old meanie, but ask someone who cares.
    and anyways, you can't diagnose over the Internets, its immaterial, incompetent, and irreverent.
    Oops sorry, been watchin too many "Perry Mason" re-runs, and did you know Raymond Burr was a Homo? Didn't see that one coming.
    Anyway, its unethical.
    OK, not as unethical as writin an Oxy scrip in exchange for a handjob from your patients redneck granddaughter, but its the same ballpark.
    Seriously, hold out for a BJ at least.

    and 9-11. Howcome they always call something thats supposed to be great a "Mecca"?
    I always say "Oh Really? so its a smelly 3rd World City closed to everyone who doesn't practice a particular religion??"
    You know, sort of like Montgomery, Alabama.
    Seriously, try bein a Jew in Alabama in 1978, Mecca would have been easier.

    and I bet U2 didn't even do the "Theme from Rawhide"


  6. dear MS1,

    the 70 year old female was a crack-ho who had just held out on her pimp. he made her act as a drug mule for him after nearly choking her to death, but she escaped and made it to the ER. that's too easy. the fissured tongue... well, that's just part of the trade. either that or you did a stat ER schilling test.

    no theme from rawhide. good point about mecca.

  7. Now, Now, keep your xenophobia under control.

    You stated best health care system in the world but mentioned a single hospital. No-one has ever said that USA does not have some of the best hospitals in the world but I'm not so sure about some of the doc's that work in them.

    And surely you remember Louis Pasteur?


  8. Anon1

    Surely you remember Hiroshima??
    And America's of great even James Earl Ray almost got a Liver transplant till Mickey Mantle beat him out...
    Thats how we treat Heroes in the US of A.
    Mickey Mantle, I mean, not James Earl Ray...
    And did I ever tell the story about my Med School Classmate James "Jimmy" Earl Ray Jr.???
    For some reason he always went by "JR"...

    Frank "nuke em till they glow" Drackman

  9. Frank! The very doctor I had in mind.
    What do you mean "Med School Classmate"? You attended med school in a purely janitorial role so you surely mean 'workmate'.


  10. Annonymous!

    at least I HAVE a fake name, you turd-burlin-cum-guzzlin-sperm-receptacle...
    and the jokes on you, I WISH I'd made what Janitors make during Med School, woulda saved alot of time I wasted down at the Plasma/Sperm Bank...


  11. 911 Doc if you work at Vandy you may well know a couple of former medical school classmates of mine. The famous OG who is a trauma surgeon and gastronome of the top order and Sheila "Tequila" McMorrow Jones in the pedes ED. Both great, wonderful, smart folks I'm better for having known.

  12. dear anon1,
    i know who louis pasteur is but certainly do not remember him as he died back before France became.... well, France. and i am most certainly not a xenophobe, i simply hate France (and Luxembourg).

    Dr Dawg,
    i do not work at Vandy and do not know your friends, but it is a great hostpial. are you a miracle college of Georgia grad?

  13. You'd thank with all that Brain Power/$$$/ they'd be able to pull off at least one SEC title...
    UGA I mean,
    Vanderbilt's the Washington Generals of the SEC...
    and don't tell me bout' there great Baseball/Basketball/Gymnastics/etc etc etc
    there's only ONE sport that counts down South...


  14. What the hell has Luxembourg done to piss you off? I doubt that you could even point to it on a map.

    Anon 1

  15. dear anon 1,
    I could so place it on a map... It's west of California... And I hate them because of their motto, translated as "we want to remain what we are." it shows a devastatingly childish worldview, but, when you are a bunch of drunken goat-fuckers, wanting to stay in this state of depravity is worthy of universal scorn (except from liberals, who do not condemn goat- fucking, as long as the goat is enjoying it).

  16. anon1:
    OK, I might not be able to find it on a map, but I've BEEN THERE, DONE THAT, and got the crabs...
    and its not a bad place, no Minorities, Navy, or Air Force, and although they have there own language, there also fluent in the languages of the countries who've taken turns invading them for the last 1,000 years.
    and I love how anythang European is automatically considered cultured and sophistocated, like the cultured and sophistocated gypsy who tried to sell me his daughter, a flashlight, and some fake MDMA.
    and Luxemburg was sorta like ATLantas getting to be, couldn't find anyone who would admit they were FROM Luxemburg.
    and if there so flippin smart, couldn't they come up with a more original name for the capital? Its "Luxemburg" which is as stupid as if the capital of Alabama was "Alabama"...


  17. Very good boys, a quick google and a look on wikipedia and you are both experts.

    Frank, you should have bought the guys daughter - a good southerner like you would have been right at home being 'massa'.

    Anon 1

  18. "massa"? somehow associated with being from the southern US? oh i get it... you were engaging in a sophisticated contra-coup sarcastic comment proving, in an elegant way, that someone who says that people from Luxembourg are drunk goat- fuckers is either putting you on or is a complete moron... just like you were putting me and Frank on! fucking spot on brilliant mate, because i can tell from reading your posts that you are not a fucking over-educated humourless moron douchebag who doesn't even understand sarcasm. (hint... there is some sarcasm somewhere above)

  19. Errrr no........ I was insulting Frank pure and simple, no sarcasm, nothing sophisticated. Insulting Frank. That was it!

    Anon 1

  20. how deliciously ironic, then, that i'm from Georgia!

  21. Annonymous 1

    still waitin for the insult...
    Oh, that "Massa" remark was it?
    thats like insulting Kobe Bryant for his 18 inch Penis...


  22. Anon,

    FYI, Frank doesn't even live in the states. He doesn't even speak English. 911 buys his posts and has them translated for posting on MDOD, you dumbass.


  23. 911, yep. MCG c/o double aught.

  24. "Double Aught"???
    Ahhh how I loved the early "00"s I mean "aughts" with the quaint "aught" that hadn't been used in nearly a century, back in the good old days of unquestioned American Supremacy and Government Sanctioned Segregation...
    and I really hate people who refer to there College/Med School with an acronym, probably cause when I used to do that people gave me blanker looks than I usually give them...
    and cause MY schools names don't lend themselves to readily recognized abreviations,like "2011 BCS CHAMPIONS!!!!!!"

    Frank, "Double Aught" Drackman

  25. Yeah, yeah yeah! Blah, blah, blah, witter, witter, witter.

    You still have not told us about the best health care system in the world. One hospital does not make a system!

    Anon 1