A surgeon’s take on health care

This has to be my favorite take on the state of health care in the U.S.

John Gary Maxwell: Health reform from my side of the surgery table

Socialism

Someday I’d really like to get the time to write out a statement about my opinions on health care reform. Until then, just know that I think:

• Everyone needs access to quality health care. This includes financial access.
• Health care coverage shouldn’t be linked to jobs. People lose jobs (and therefore insurance).
• I like the idea of a single-payer system but admit the transition would be difficult.
• Americans think they deserve the best health care that someone else will pay for.

Don’t read too far into my political views based on what I just said. I assure you they are more complex than I can jot down in the five minutes I am taking to post this.

Too often people think that the government isn’t capable of running anything, let alone healthcare. So I was amused when I saw this comment on a website. I don’t know who wrote it, but it’s food for thought.

This morning I was awoken by my alarm clock powered by electricity generated by the public power monopoly regulated by the US Department of Energy.

I then took a shower in the clean water provided by the municipal water utility.

After that, I turned on the TV to one of the FCC regulated channels to see what the National Weather Service of the National Oceanographic and Atmospheric Administration determined the weather was going to be like using satellites designed, built, and launched by the National Aeronautics and Space Administration. I watched this while eating my breakfast of US Department of Agriculture inspected food and taking the drugs which have been determined as safe by the Food and Drug Administration.

At the appropriate time as regulated by the US Congress and kept accurate by the National Institute of Standards and Technology and the US Naval Observatory, I get into my National Highway Traffic Safety Administration approved automobile and set out to work on the roads built by the local, state, and federal Departments of Transportation, possibly stopping to purchase additional fuel of a quality level determined by the Environmental Protection Agency, using legal tender issued by the Federal Reserve Bank. On the way out the door I deposit any mail I have to be sent out via the US Postal Service and drop the kids off at the public school.

Then, after spending another day not being maimed or killed at work thanks to the workplace regulations imposed by the Department of Labor and the Occupational Safety and Health Administration, I drive back to my house which has not burned down in my absence because of the state and local building codes and the fire marshal’s inspection, and which has not been plundered of all its valuables thanks to the local police department.

I then log onto the Internet which was developed by the Defense Advanced Research Projects Administration and post on freerepublic and fox news forums about how SOCIALISM in medicine is BAD because the government can’t do anything right.

An account of my Chicago weekend

I was able to go to the American College of Osteopathic Surgeons conference this past weekend in Chicago. I treated it as a mini-vacation. I love Chicago.

 

FRIDAY: I went to class in Des Moines all morning and walked around in downtown Chicago all evening. How cool is that? I’m getting ahead of myself though. On the plane there I experienced the single biggest jolt I have ever felt on an aircraft. Sometimes in rough air you can look around and see everyone tensed up, but with this one single jolt the entire cabin actually audibly gasped (like a startled, hushed scream). It was really windy out but I think it also must have been new pilot training day because it was not smooth sailing. I got to the airport and took the subway into town – about a forty minute trip. Then I started walking east toward the hotel. After about twenty minutes of walking I snapped a nice picture of the sunset with my cell phone. Then it hit me – sun sets in the west. I had been going the wrong direction for a long distance. I finally made it to the hotel 2.5 hours after touching down. I was exausted but set back out on foot to find a decent place where a guy can eat by himself and not feel awkward about it. I passed a grocery store on the way back to the hotel and decided to check it out so as to experience what daily living in the heart of the city was really like. I returned to the hotel with a pop and a single beer. I enjoyed the beer and then decided to walk to Millennium Park. It was late on a Friday night and people were all dressed up for Halloween – I even saw a person in an all-out mascot suit (big stuffed head included) riding a bicycle down the street. While at Millennium I was lucky enough to see a firework show coming from Navy Pier. I went home and crashed.

SATURDAY: I got up and walked to the Field Museum. It was cold, I was under-dressed (insulation-wise), and the walk was LONG. Much longer than I thought. With blistered toes and a runny nose I made it to the museum. My legs were tired but just the thought of a museum to myself gave me an energy boost. It wasn’t busy at all. I’ve always wanted to go to the Field Museum by myself, just because I don’t think anyone else is as giddy as I am about that sort of thing. When my heart was content, I did the smart thing and took the cab to the hotel. There were some other DMU students coming to town and I was ready to emerge from my solitude. While waiting for them, I walked to the bar across the street to see if I could catch the ISU game (the bar advertised 42 TVs so I figured my odds were best there, but alas, no game). I got to do another thing I’ve always wanted to do – show up at a bar alone and see if I have what it takes to make some stranger-friends. The place was packed and I sat at one of the only open stools at the bar. These really drunk people started talking to me and long-story-short it turns out they were med students from Kansas City! I assumed they were also there for the conference but this was not the case – just a really strange coincidence! I also learned that a one-bedroom apartment downtown costs $2000/month! When the economy was better it was closer to $3000! And parking spots cost nearly as much per month as my share of my apartment in Des Moines! After a good time with those guys I finally got a call from my classmates who were two hours late because a car took semi truck’s mudflap to its radiator back around Davenport. Amy, Jimmy, and I walked around downtown to find a restaurant to eat at and finally settled at a brewery. Amy was dressed as Indiana Jones (complete with hat and whip) and Jimmy was a Boeing ground crew member (complete with yellow reflective coat and ear protection, but without the glowing orange sticks to direct planes around with). I was lame and dressed as myself. We then walked FOREVER to this strange bar to meet up with other med students from around the country. We thought someone had played a joke on us – the bar was really weird (it was named The Funky Buddha) and was full of men dressed as women and whatnot. Halloween, I guess. Or the regular crowd. Who knows? Mixed drinks were $10 so I got pretty drunk on water. There were VIP tables, but no one was at them, so we took one until we got booted to the dance floor with the other med students and all the, uh, uniquely-dressed people. We took a cab home and hit the sack.

SUNDAY – my reason for being in Chicago. The conference was interesting. We went to some good talks and some boring ones, but I learned some things. Probably my favorite tidbit: a neurosurgeon in Iraq gave a talk about the military surgery hospital there. During his time in Iraq two people came in with explosive devices implanted in their bodies. Really! It’s not just happening on Grey’s Anatomy. It was a good day, but there isn’t much that can be said that makes for a good story. I walked to the train station, rode it to the airport, and flew back to Des Moines. Back to reality.

The Onion: as credible as Fox News, but funnier

A little medical humor for you.

Anonymous Philanthropist Donates 200 Human Kidneys To Hospital

Alexis Carrel

Have some free time? Want to learn about an eccentric pioneering surgeon?

I knew it!

Here is a paper I wrote for a History of Surgery contest here at Des Moines University. I will post a link to the contest site on the DMU website as soon as it is updated.

Alexis Carrel by Adam Kapler DO13 (you might have to right click > save as…)

I don’t really want to toot my own horn here, but I do want to get this paper on the net and indexed. Maybe someday if you Google Alexis Carrel your search results will contain my paper! It’s not exactly primary-source-material but some high-schooler somewhere might find it helpful. One can dream…

I am now very indebted to this man (Carrel, below), Howard A. Graney, and the surgery department here at DMU! Thank you!

Text-only version below the fold… download the PDF for the full effect (pictures, additional tidbits, and looks better formatted).

Happy Conquistador Day

Today is Columbus Day. It’s stupid. From my Facebook status:

Christopher Columbus shouldn’t be celebrated. The man raped, murdered, and converted his way through the Caribbean. It was genocide. Yet, revisionist history prevails.

I should add that all that raping, murdering, and conquering was done in god’s name. This guy was even a candidate for sainthood (Catholic) 1866. Ugh.

Try reading the first chapter of A People’s History of the United States (by H. Zinn) and tell me why this guy deserves celebration. Why insult the Native North Americans?

Don’t get me started on Thanksgiving…

Update: Anatomy and misc. (Go Clones)

I forgot to mention that we already had some patient contact. Well, sorta. We had to dress up in full physician garb (shirt, tie, slacks, and a fancy white coat) and meet with patients and extract information from them. They were actually actors. The woman patient/actor I had was convincing to say the least. I thought I would have trouble taking it 100% seriously, but nope. We get videotaped and are required to watch ourselves interact. I had to do the same thing while student teaching… and let me tell you… videotaping yourself and then watching critically is sheer agony. Everyone is hardest on themselves. It wasn’t so bad. Three more of those this year, and then eleven of them or so the second year. It will be more fun once we start physical diagnosis.

Anatomy! Anatomy lab is interesting to say the least. Gertrude, or Gertie, is our cadaver. What follows are answers to questions I anticipate people might ask….

• We know her age and cause of death, but that’s it.
• There are five people to a body. Two cutters per side of the table and a “navigator” that reads through the lab guide and displays diagrams and tells the others what to do. There is a big LCD TV monitor above each body. It displays the lab manual and anatomical diagrams. Works pretty slick – lab manuals don’t get gross.
• There are probably 30 cadavers in the lab, which means that there are 150 of us in lab at a time – med students and physical therapy students, mostly.
• The bodies are embalmed. So there is no blood and no decay. The lab is extremely well-ventilated, but the smell of embalming fluid can be a little strong.
• From what I’ve heard (lab rumors and insider info from Mr. R. J. Gunderson) the bodies might have been dead for nearly a year. Some definitely look fresher than others.
• We wear scrubs and lab coats. Our tools: scalpels, probes, tweezers, scissors (things you used in high school dissections pretty much)
• It’s harder to tell the sex of a person than you’d think. They are all naked and face down with shaved heads. On day one, we worked for a good twenty minutes on what we thought was a man, until a keen eye alerted us otherwise.
• Elderly people are not the best example of superb muscle anatomy.
• Anything we cut off (lots of loose tissue scraps and fat) gets put in a special bin. The remains of the body, and all the scraps in the bin, will be cremated and given to the family.

That’s about it for now. I have a History of Medicine exam first thing in the morning. Interesting stuff – I will miss that class. Bloodletting and mesmerism and trepanation… we’ve come a long way, baby.  (And yet, crazies still linger: homeopathy, faith-healing, most acupuncture, some chiropractors, GNC stores, magnetic bracelets, Carolyn Walker… don’t get me going…).

We have class/lab six to seven hours per day and then have lots of studying to do aside from that. And eat/sleep. I’m struggling to keep up. I don’t know how anyone could keep up. Maybe no one is.

One more thing: Cyclones will beat the Hawks, 20-17.

Like natural oddities?

Interesting little article.

7 Phenomenal Wonders of the Natural World | WebEcoist | Green Living.

I’ve put this off for far too long

Gotta keep this quick. Need sleep.

Where did I last leave off?

Medical school started. That was almost a month ago. Wow.  My brain is now dead for the day, so here come random things to share:

• The courses that take up the majority of my time right now: biochemistry, anatomy, osteopathic manipulative medicine, behavioral medicine (a doctor-patient relationship course mixed with lots of psychology), and history of medicine.
• Time flies when Biochemistry takes over your life. I’ve already learned more in that course than I did in all of undergrad biochemistry. Too bad my exam scores don’t reflect that.
• Overall, we have already had three exams. The pace is fast. Too fast.
• Throw everything I learned in grad school (science education) about how people learn best out the window. Whereas the important thing used to be to get a good understanding of general processes and subject matter, now the intricate detail of what we are supposed to know is overwhelming. Sometimes it feels more like memorization and less like learning, if that makes any sense.
• We have these labs, which I will just call palpation labs for now, in which everyone is feeling and prodding everyone else, looking for landmarks that lie beneath the surface of the skin, checking alignments and asymmetries of bones and whatnot… well, as you can imagine, it was awkward at first. Feel your tailbone. We had to basically press on the underside of that. Now imagine locating a stranger’s pubic symphysis. Take a good guess where that is. We, the med students at DO schools do this, and the MD schools don’t (it might be an elective). It takes up a huge part of the curriculum for the first two years, and I was worried that I wouldn’t like it. However, the awkwardness wears off really fast and it is actually a pretty enjoyable learning experience. Now if only I were good at it.
• People are way too smart. Anyone who felt smart in high school got to college, where the “smart” kids go, and found the playing field leveled. Now, I find myself amongst the smartest of the college kids, and sometimes I wonder how I got in. Maybe someone made a mistake and accidentally sent an acceptance letter. I’m kidding, but I really envy how adept some people are at picking up this knowledge at the pace they are throwing it down.
• Thursday is the big day… I get a cadaver. I might have to dedicate a future post to this. Taking a scalpel to human flesh for the first time has got to be unforgettable. I mean, this is human dissection. Wow. I’m really hoping I get lucky: overweight people require lots more work and their tissues never, um, clean up as well; and elderly people tend to have atrophied muscles. A marathon runner on the slab would be nice.
• I think when I look back and wonder how I survived this first month, three things will come to mind: Ryan Adams, Gobstoppers, and this video:

• I’m tired. Enjoy some SMBC:

Orientation week.

Things are changing fast. I worked my last day at the Science Center on Saturday and started orientation on Tuesday. Orientation has been about as dull as I expected. (Example, during computer training: “this is where you plug in the power cord.”) Part of me feels like I should be attending more events and trying to meet more people, and the other part of me is really glad I’m not giving in to forced socialization. There will be plenty of time for normal socialization.

It’s starting to feel real. We have a schedule now, I have a locker and mailbox, I got my picture taken in a lab coat for my ID badge, and they even already talked about how to deal with mild depression. Seriously. My assigned advisor was one of the doctors who interviewed me. Good story: on interview day the conversation somehow turned towards hobbies, and then motorcycles came up and, long story short, I walked out of there pretty sure that if I didn’t get in to DMU it would be because I didn’t always wear the motorcycle helmet. After all, how should I be expected to save lives when I show such casual disregard for my own? Anyways, I got in, and she remembered the motorcycle helmet conversation.

Tomorrow I should get loan money deposited into my bank account – so much money that I might be tempted to drop out of school, buy a new Corvette, and flee the country. If you don’t hear from me for a while, try Canada.

It have heard twice now that starting medical school is like trying to take a drink from a fire hydrant. Monday they turn on the water. I’m thirsty, but not that thirsty. Yikes.