Saturday, November 23, 2013

Fifty Years Later: Reflections on Assassination of JFK

The loud speaker in our Jefferson Township High School government classroom suddenly came on with the voice of Walter Cronkite announcing that the President had been shot in Dallas, Texas.  We left the classroom shortly thereafter when the bell rang.  I went to English class, where, shortly after about twenty of us seniors got another jolt when the continuing news feed from Walter Cronkite announced that the President was dead.

A couple minutes later, the radio on the speaker was turned off and we were jolted from our grief slightly when Miss True announced that we might as well go ahead and take our English test since we can't do much about the assassination of the President.

It was Friday, November 22, 1963.

I felt empty.  The next week, I took the SAT's for college application purposes.  The Army- Navy Game was delayed for a week and ended with Army confusion on the two yard line -and Navy headed for the Cotton Bowl to play Texas was played while I took the test.  I wanted to see that game on TV since I wanted to go to West Point.  But, my SAT score helped me get a nomination from Congressman Robert Taft to the Academy.  I saw the 1964 Army- Navy Game in Philadelphia wearing Cadet Gray.

I was glued to the TV for the next 3 or 4 days during Thanksgiving Week after the assassination, watching news with the tragedy and the mystery unfolding before the eyes of the nation.  We saw Lee Harvey Oswald in custody for the murder, then murdered himself on live TV by Jack Ruby.

We saw the funeral of the President.  Jackie, the widow and the two, now fatherless, children faced every TV camera in the nation, it seemed.  The nation mourned together. Thanksgiving week provided a buffer for processing the shock and grief a bit more before returning to daily routines.

The Class of 1964 is now planning its 50th reunion.  How the time flies.  Our high school was bulldozed into rubble last summer.  We have our grandchildren, retirement (or delayed retirement with the present economy), declining health, medical expenses, painful parts, etc. to focus on.

What did it all mean?  What did we learn?

Dreams can be shattered.  And rebuilt while the wounds heal.  Loss and grief happen - again and again.  They are never "resolved".  They are reconciled.  They settle into who we are.  Our shared identity includes our shared grief as a nation.  In our modern era, 9/11 sits in our hearts and brains like an anvil of loss and grief.  But we remember Miss True's lesson as much as the rest of the events of November 22, 1963.

Move on to the next test.

Thursday, November 14, 2013

75,000 Views: Thank You Readers!

Thanks, Folks for reading my posts.  I hit the 75,000 views milestone today.  I'll keep blogging, now that I'm warmed up.  I love Family Medicine and learning about how to help patients in a neighborly, affordable way.  It's not always easy in today's changing health care (non) system.  Writing about it makes it clearer and more meaningful.

We need more Family Physicians.  Currently there's no way we're getting many more, so American creativity is called on to make solutions.

Churches should get into health care locally as one strategy.  Cable TV has to be used in the care of some chronic/ stable diseases, too.  Phone apps, texting, patient controlled medical records, etc are other ideas to stir the pot of better health at lower costs.

We will have to crank up our mutual problem solving strategies to "Bend the cost curve" in the short and long term.  Otherwise, "The Beast", delivers more bankruptcies to our communities and the hole gets deeper.

Being a Family Doctor is still fun, challenging and rewarding.  I love it and I enjoy writing about many aspects of the doing and teaching of it.

I'll be writing more about Direct Primary Care as one of the solutions to the health care financial mess.  Likewise, I'll write more about the power of the human spirit that I see in patients, their families and health care workers every day.

Humans were given a sense of the sacred and a quest for meaning that helps Family Doctors a lot.  As we quest together to understand our humanity and our Creator, let's remember to be neighborly and show our care for each other and our appreciation for God's mysteries.  Onward, together, we can get through the transformation of healthcare.  Humans in teams and tribes can help each other.

Monday, November 11, 2013

Veteran's Day Reflections-- 2013

When I hear someone mention Veteran's Day, November 11, 1918 comes to mind quickly, followed in a micro-second by thoughts of Vietnam and the United States Army.  Then West Point and the Hudson River Valley looking up the river from Trophy Point-Beauty, Peace, Order.

 Duty, Honor, Country.

The Wall.  Twenty names engraved in it from the West Point Class of 1968.  Taps.

The Flag of the United States of America.  The National Anthem.  "The land of the free and the home of the brave".  America.

Serenity.  Reconciliation.  Somber moments honoring those who lost their lives in service to this great nation and those who still serve and protect us.

We served as ordered.  We did our jobs.  We grew.  Thank You, America, for being the best nation in which to be a military veteran. We've learned together- since Vietnam when you were confused about who should answer and who should honor those who served in the "wrong" war.

America.  America.  God shed his grace on thee.

Thanks to all you military veterans who served and all you folks who continue to serve and protect us.


Friday, November 1, 2013

Family Medicine: One Hundred Eighteen Patients Today

I finished with various responses to the pile of papers, forms, reports and letters from various insurance companies.  It looked big.  So... I counted.  NINETY-TWO PATIENTS were represented by this pile.  I was surprised.  I was also discouraged.  There is no end in sight to the ridiculous waste and harassment by various entities in The Beast (Medical Industrial Complex).

AFTER, finishing with the last patient, I attacked the pile.

BEFORE the pile, twenty patients had presented themselves for various aspects of our neighborly Family Medicine practice yielding various diagnoses such as:  Well child exams, HTN, asthma, COPD, GERD, FMLA form, Health Maintenance-immunizations, mammogram ordering, colonoscopy discussion and referral, deferred immunization options for under-immunized, physical examination.  Contact dermatitis, multiple benign nevi, insulin resistance, snoring, sinusitis, allergic rhinitis, overuse syndrome-legs, venous insufficiency with edema of lower extremities, degenerative osteoarthritis of knee with effusion, acute situational reaction to custody hearings, acute situational reaction to relationship stress, GAD, ADHD, Depression, Insomnia, OA C-Spine, Degenerative Disc Disease C-Spine, Med Management opiates, Ureterolithiasis with hydronephrosis, nephrolithiasis, abdominal pain, acute viral bronchitis, Calf pain, family hx early coronary disease, uncontrolled type II DM, noncompliance with medical therapy, lumbar disc disease, trochanteric bursitis, fatigue, macrocytosis, hyperhomocystenemia, micro-albuminuria, family hx colon cancer, hematuria, menopausal symptoms.

Yes, there are many more than twenty diagnoses. There were more than I've noted above, even, due to the vastness of my scope of practice, which patients realize, appreciate and sometimes misuse (but we love them, so we're vulnerable when they ask for help and pile on three or four extra problems)

AFTER these many and several diagnoses/assessments in the twenty patients, six medical questions presented from patients calling in.  These were dispatched with a recommendation for clarification, office visits or urgent refill for one (when pt was in for acute, unrelated symptoms, "forgot" to get chronic disease med refilled and has one pill left- I succumb to one 30 day refill if pt agrees to make appointment to deal with chronic disease mgmt before we call it in-yes, it's coercion- or the practice of medicine).

We collected two hundred dollars today from insurance and patients.  I sense a bit of a problem, Folks.
This may not be a sustainable model of practice.  It's interesting and challenging.

What do you think?