Alive and Kicking

Contrary to what I can only assume to be popular belief, I am alive and well.

Much to my surprise, or at least cautiously optimistic belief, I successfully defeated the modular of Brain and Behavior. A nine week behemoth, it was advertised to be the most challenging module of the first two years of school- a reputation it seemed both pleased to have and eager to maintain. The most enjoyable result of being done? No more anatomy. A year ago we started in the cadaver lab and have sense made our way from the heart and lungs, through the GI tract, all around the GU system, up and down the extremities, and lastly into the brain, head, and neck. While dissection lab was usually pretty nice and a change-up from regular lecture, it's really nice to be freed from the afternoon time commitment and additional exams.

We're now into the module of Blood and Lymph which is going fairly well; it's very pathology focused which might mean a test that has its devil in the details. I still want nothing more (going on 2 weeks later) than to revel in the joy of being done with B&B, but have decided to get back to the grindstone. If I'm going to dance on the grave of this semester, I want to be damned sure it's dead. I don't know if it's cold in the ground just yet.

So that's what's going on. Fiction writing is still happening, slowly, but I am currently planning on waiting to post more until I have a better story formed.   If I had more time, I'd like to be able to finish NaNoWriMo on time. I suppose with my late start, it'll just be a two/three/four month excursion for me. I mean, I'm a little busy with not shaving this month...

It is November, after all...

Until next time.

Not Quite The Beginning - Part 2

Carter grimaced when he saw the number. Pushing the side button on his phone, the call disappeared from view but remained in his mind. Could it have really been 3 years? Leaves crunched under his feet as Carter cut through the small park toward his dreary apartment building. The wind nipped at his exposed skin and forewarned the coming cold front and autumn storm. Trash littered the worn stoop of the old brick building before him. Dropping his shoulder to push open the heavy door, Carter doubted himself. Did you really think he wouldn't show up? Come calling as soon as he was out? You know him and you know he'll never change. But can't I change, he thought, arguing with himself.

After he had climbed the four flights to his one bedroom apartment and set down his bag, Carter's phone vibrated against his thigh. The accompanying tinny ringtone stopped when he pushed the talk button.

"Carter Hamilton, it's about time you picked up," Jackson's familiar voice said. "You really gonna leave an old pal like me hanging?"

"Jackson," Carter said, "how are you doing?"

"What do you mean, 'How am I doing'? How would you be after breathing free air for the first time in 3 years? I'm fucking fantastic. Glad to be out of that concrete shithole."

"I can imagine," Carter replied. Specks of dust drifted through the air in front of him, catching the evening light.

"Well now, no you can't, can you?" Jackson spat. "You weren't caught. Weren't even arrested or talked to, if I remember correctly," he added. Carter stopped pacing. Seconds ticked by. "But, let's not rehash the past. A new leaf and all that bullshit." Carter heard the squelch of a train through the phone.

"What can I do for you?" he asked. Unease twisted through his stomach, as he waited for the words he knew would come.

"I've got a job," Jackson replied. "And I could use your services." Carter felt bile seep into his throat.

"Jackson," Carter began, "I don't know if I ca-"

"You shut it. Stop right there," Jackson interrupted. "I don't want to hear a thing. Not one word. I knew you'd go soft with me gone. You never had a damn backbone." Carter closed his eyes and willed himself to say something, anything. "I don't know what you don't understand. You're the alarm guy. That's it. You deal with all the electronic crap, cutting your wires, and I handle everything else. Stealing ain't exactly a complex science."

"You don't understa-" Carter stuttered.

"No," He said. "Just meet me in an hour at the old diner on 23rd. I could use some real food." And with that, Carter heard the line go dead.

Not Quite The Beginning

As they ran, the alarm slowly faded behind them. This wasn't how it was supposed to happen, Carter thought. He and Jackson darted through the alley, their footfalls heavy and loud on the uneven concrete. No one was supposed to be there. No one was supposed to get hurt. Rounding the corner, Carter saw the flashing lights of police cars. He felt grief well inside him, the ocean of inevitability pulling him into the undertow. Jackson, struggling to keep up, gained ground as Carter stepped from the alley and abruptly stopped at the edge of the road. The wail of the police sirens grew as it bounced from the empty buildings. 

The first of the black and white cars whipped around the corner. Knocking Carter to the side as he ran past, Jackson darted into the street. Carter felt the world slow as the cruiser's brakes locked into a skid. The bumper clipped Jackson's legs at the knee and bounced his body off the hood. He flew forward into the air. His face hit the pavement with a wet slap. The bones in his neck cracked with a hollow pop. Carter stared, aghast.

"Sir!" The policeman yelled, as he jumped from the car. "Sir, are you alright?"

Blood seeped into the cracked cement. Carter looked up and saw police cars surrounding the area. He looked to the growing crowd of policemen.

"What happened?" a patrolman asked.

"Is that the suspect?" another said, motioning to Jackson's lifeless body. The officers looked to Carter. Their faces wore concern beneath the flashing red and blue lights. The sirens had ceased, giving way to disturbing silence.

"Sir, what did you see? Do you know this man?" the original officer asked. Carter looked to them in disbelief. He realized how the scene must look to the policemen. They don't know what happened, he thought. Jackson's dead eyes looked through him from the street. Carter felt a heavy weight creep into his stomach. The tar brewing inside grew thicker as he paused, choking to keep it down.

Taking a shuddered breath, Carter began to speak.

Nothing But The Rain

Throughout my life, my hobbies and interests have widely varied. I can remember devouring everything I could about ancient Egypt and dinosaurs in elementary school. This transitioned to drawing and sketching to playing percussion which lead to freestyle biking to golf to learning the guitar. My unending desire for knowledge and the revolving door of activities that engaged me have both given me countless experiences. The changing focus resulted from my starting something new, tearing through it as fast as I could until I felt I had a good handle on it, then being stolen away by something else. Fortunately, the spoils of my sporadic nature have never completely abandoned me when I seemingly ditched them. I love riding my bike when I get the chance, obviously still draw and sketch, occasionally hit the links with my friends, and maintain a prehistoric presence in my life (Winston, duh).

Certain passions, however, have endured throughout my life. One of my greatest can best be described as a love of the story. Since Kindergarten, I have loved to read and have been drawn in by books and stories. From Dr. Seuss to The Boxcar Children and Goosebumps to Scottish detectives, a perpetually walking man, and a sprawling epic, this has grown throughout my years and manifested most obviously in my studying English in college. Yet, my interest in stories has never been confined to just the written word, bound and printed. Movies, TV shows, plays, musicals, bands? They can all show the complex weave of human interactions and emotion. And I love it, being more than willing to commit and dedicate bits of my elusive free time (namely whenever I can't hang out with my wife/friends and my brain can no longer handle studying).

An interesting addition began during college. Rather than merely taking in the stories, I began to produce my own, writing fiction, first for a writing class and then for fun. Much to my chagrin, the time-sinks of life and medical school stopped any continual creative progress. This fact has been sitting my mind, gnawing at my post-central somatosensory gyrus (not really- I'm just in the Brain/Behavior module right now). Throughout the day, I'll imagine bits of scenes, shadows of characters, and inevitably think I should write a story with this. Considering the frequency of my blog updates, you can imagine my success rate (hint: dismal).

Because of this, and in an effort to change it, I'm going to try and write- short stories, scenes, chunks of dialog- and probably post them here. Will these be complete stories? Good stories? Worth reading? I honestly don't know. As any writer or would-be-writer will tell you: writing is hard. It's work; it's tough; but, I think it might be worth it.

In closing: what are some of your favorite stories? Personal stories, books, movies, TV shows, anything. Feel free to post away, if you're out there.



Until next time.

A Severe Lack of Free Time

Pretty Shameful

My heart sinks and dies a little bit every time I read something like this.

Do people forget that any greatness the country has comes from its freedoms? You know, including Freedom of Religion? Does anyone really think things would be better if we were all the same? Do people not realize that there is a huge difference between Islamic Extremists and a person who is simply a Muslim? Just like there is a huge difference between a crazy member of Westboro Baptist Church (aka Fred Phelps) and a person who is a Christian?


Until next time.

A Little More Personal

In honor of a previous post of mine, I've decided to again talk about things I like and/or like to do. This stems not out of disdain for my current academic situation as before; we've only just begun second year and I think I'm going to like it. Instead, this blossoms from my simple desire to think about things I like and have something to do while my better half isn't around. So, without further ado:

Things I Like More Than...Other Things?


-Extra computer storage space. External hard drives, USB sticks, blank CDs/DVDs, I am an equal opportunity advocate. I don't actually know why I have such a fascination with extra space (I may or may not have three external hard drives, two USB sticks, three spindles of discs, and an iPod), but I think it goes back to a feeling of freedom and potential. Do I have space to buy that [electronic media]? You bet your ass I do. I have space three hundred times over.

-Naming inanimate objects. This partially ties to the previous comment as I also name all of my computer drives (don't tell me "T-REX" isn't cooler than "C-Drive"), but it goes beyond that. My computer? Persephone. My T-Rex? Winston. Turtle Ottoman? Herbert. iPod? Nightwing. Phone? Alfred. Doing so just gives everything a bit of punch and personality. Try it. Need to kick you off? Spartacus.

-Discovering my water bottle to be full without remembering having filled it.

-Forgetting about E-learning assignments for class (online assignments) only to find that we never had any.

-Stepping outside on the first real day of Autumn. The air has just enough chill that you know Summer is finally over.

-Fruit snacks.

-Having a good author draw you in and then finding out he/she writes a series or has additional books.

-An indie girl, an odd but wonderful group of people, and two crazy Frenchmen.

-The Library.

-The Wire. I'm through season 3 and would argue it's the greatest story told on television, and I'm a frakkin' Lostie. ((+10 nerd points if you know what else I'm referencing here)).

-The unusual feeling/pain that you feel in your face after laughing so hard you start to cry and can barely breath. This exclusively happens with friends, usually when ridiculous stories are being told.

-Anything that satiates my ridiculous need for trivia.

-The ultimate gateway fruit.

-Hanging out with old friends, and feeling so at home it's almost like you never left.



Thoughts? I'd love to hear them in the comments below.
Until next time.

Unforseen Difficulties

The preparation for medical school is ridiculous. If one were to try to compile all the possibilities together, I have no doubt the process would be damned near infinite. Some people start prepping in high school. They take tough science classes, shadow docs, and begin the process of building up a history of interest in medicine. This way, when college rolls around, they can reference all that they've done so far. Then college consists of pre-med courses, volunteer work at hospitals or labs, the entire MCAT preparation and process, and -topping it all off- the application process. Buckets of forms, letters, grades, personal statements, and interviews.

There's a lot to do.

Assuming all of this works out, you're all of the sudden in medical school! You get to become a doctor! Your hard work has paid off! What does school do? Well, they continue with preparation, but this time it's to really become a physician (for now we'll ignore the residency process needed before you can become a practicing physician). In other words, the journey continues.

Some of you might be saying, "Wow, that sounds pretty tough." You, Hypothetical Constant Reader might be right. I won't argue that the process is lengthy and can be challenging. It's true. But I believe the real troubles arise from the unforeseen difficulties. The problems that pop up and create situations you've never even begun to consider in your- literally- years of preparation. All of that preparation has been so that when problems arise, you have the skill set and ability to assess and act. A child presents with shortness of breath. Assess and Act. A young man becomes violent and aggressive as he pesters you for drugs. Assess and Act. An old woman codes on the hospital floor. Assess and Act.

But what happens when unforeseen issues arise within the process of your preparatory education? How do you handle the different thoughts, opinions, ideas, and behaviors of your fellow students and teachers? The situations that arise away from the classroom? How do you assess and act? Do you stick to your own Self and values, possibly straying from the carefully constructed path of the Medical School Journey? Or do you keep quiet, noting your feelings, and hope for the best?

I suppose the real question is: can a person really complete this journey through medicine and end up the same core person at the finish line?

Now you might be asking, "What on Earth is he on about?"

Don't fret, Constant Reader. I'd say all is and will yet be well.  I simply sit here thinking, on the cusp of a new year, I see all of the new M1s going through orientation. They anxiously and awkwardly begin their journey. Cramming onto a charter bus to breeze through the other campus. Nervously accepting the white coat in front of your peers. Awkwardly talking and drinking at the parties.  I can't help but wonder, how different am I from them? Have I changed over the past year?

Looking back, I'm surprised by how much medical school, and all its tangential connections, have factored into my life in so many different ways. One year ago I wrote my thoughts and hopes on beginning school. Rereading those words now, I feel as though I managed pretty well. Was it easy and did I ever do it alone? Of course not; no way. Many thanks to all who've helped me (especially a certain redhead).

Two points of advice, however, given then by someone who is still wiser than me now, stick out more relevant today:

-Don't be dazzled by bullshit.

-Make sure all things pass the smell test for veracity, virtue, and truth. 

I think those are good things to think about and constantly return to. All things considered, I'm looking forward to my second year.


Until next time.

A Very Talented Man

Last Saturday, nary a week ago, I attended the kicking wedding reception of my two friends (these ones: here and here). The beer flowed tastily, if not entirely clearly, from the tap. The speakers thumped with a good mix of dance music and people were out tearing up the dance floor. For those of you who don't know (which I don't imagine to be many), I occasionally tap my foot to music. Or...well...how else could I put it?

If there's a party with good music, I will dance like hell all night.

I imagine this to be an accurate representation of both myself dancing and others' reactions. I call those others "losers who should be dancing."

This has never been a problem before. I wouldn't even go so far as to call it a problem in this circumstance, it just had... unforeseen consequences. Literally not seen.

Let me begin by stating my new, and now passionate, belief: drinks should be restricted from the dance floor. Be honest. Have you ever been able to really dance well holding a drink? You're always worried about someone bumping into it or you spilling it on yourself or someone else. You may just be worried about losing any of your precious drink, not even on yourself or others. And forget about looking good while dancing and holding a drink. One arm either becomes a magic stabilizer and awkwardly doesn't move while the rest of your body shakes, or you opt for the up-in-the-air, my-drink-is-safer-up-high hold. Either way, it just doesn't work out. The solution? Ban drinks from the dance floor. It would make everyone less worried and look cooler.

Such a ban would also prevent awkward, dance-ending injuries that freakishly happen out of nowhere and could obviously happen to anyone not just a guy who was GIVING it on the dance floor and has genetically lax knee ligaments.

Obviously.

It's true. I'm such a talented man that God Dance and God Awesomeness must have taken note and said, "Whoa. That is too much dance for a mere mortal. We must stop it. Brother God Misfortune: shut him down." And down he shut me. With a perfect storm of events, my left foot at once betrayed me, jutting quickly to the side of my body riding that frictionless train of spilled beer. Mere nanoseconds later, at the moment when my foot jumped from the beer train and landed at a standstill on dry floor, my body was jostled- unmaliciously- by a fellow dancer. This led Left Knee, previously one of my most dependable soldiers on the battlefield of dance, to be attacked on simultaneously on two fronts. Painfully, he exclaimed,"FFFUUUUUUU[[CENSORED]]!" and hit the ground.

My left knee popped, buckled, and I went down. Having had a past experience of dislocating my right patella and it being surgically repaired, I was worried and cautious. I hopped up and was able to get off the dance floor and onto a nearby bench. The knee felt really tender and sore, but fortunately did not have any sharp or continuous pain. This took any kind of a bone break off the table for my differential diagnosis, but ratcheted a ligament tear to the top of the worry list. Being the stupid man that I am, I tried to "walk it off" and do a few laps around the place. I was able to walk,which was definitely a plus, but could tell it was going to be out of commission for a while. My caring but concerned wife and I were able to make a quiet departure from the reception, grab some NSAIDs and ice from a friend in town, and make our way home. Over the next few days I made a doctors appointment and self-prescribed the RICE protocol and ibuprofen. My knee seemed to improve and I became mildly confident it was a sprain with no tears. Yesterday, the real doctor concurred with my diagnosis. He recommended I take it easy for a week and then slowly work back to normal use and exercise. Also advised was this bold fashion statement.

I fully expect it to become the hot and wild new trend of the upcoming fall fashion season. I hear it's already huge in Europe.

Pretty strange events, all things considered. My advice? Keep dancing like hell. If you don't already, give such dancing a go the next time you have the chance. It's just too damn fun not to.

Until next time.

Not Quite All-Star Material

I've been in a bit of a dry spell with the blog. Who knows why we've had this high pressure system for so long, but I've decided to go ahead and rain some words down for y'all.
(Y'all? I don't know either. Just go with it.)

So, in honor of my trying to return to form, I'm going to tell you a little story.

As stated previously, I'm currently working in pediatrics. It's been a really good experience thus far, and there have been some really interesting cases and children. This seems to be a general trend in medicine. As much as any other profession, it offers wonderful examples that solidify the simple truth that people do interesting things (to say the least).

[Exhibit A: The man who was ruthless attacked by a pasta noodle.]

When kids are added into this mix the results can truly take off. I just imagine all the things adults are capable of and add in the non-existent social rules that govern children. They will say and do just about anything.

Picture yourself as a young medical student. You're in clinic and seeing a hilariously talkative 4 year old Boy who's at the doctor for throwing up. After checking things out with Mom and Boy you go present the case to Doctor. (Boy, by the way, is essentially healthy. The source of his emesis? Eating too many bed time snacks. No joke.) Upon returning to the room with Doctor in tow, Doc and Mom proceed to talk some things out. You, as Medical Student, are sitting quietly on the stool and observing. At this point, Boy is quietly sitting on the footstool and intently looking back and forth between You and Doctor. Boy then slides his stool up to you, right in your grill (medical term). He leans in -leading you to lean in, as if you're sharing a secret- and, looking at Doctor, asks:

Boy: Is tha'chya Momma or ya Gran Momma?

You: *Blank Stare* (trying not to laugh)

You: What?

Boy (much more intently, while motioning with his head): Is tha'chya Momma or ya Gran Momma?

You: What? Neither! That's the doctor!

If you can come up with a fitting reply to that, I welcome it for the future. Another scene from the same visit:
"What do you normally eat for a bedtime snack?" the Doctor asks.

Boy pauses, as if this is some kind of a trick. He boldly replies,

"Oatmeal!"

Her brow furrows in disbelief.

"Oatmeal?" she says.
A grin slowly creeps across the boy's face.

"Cookies!" he quickly adds.

This was obviously a very entertaining visit. Occasionally, however, the excitement comes not from the patient but the doctor. Or, in this case, the medical student.

I suppose I should just come out and say it.

I hit a kid in the face.

And made him cry.

I know what you're thinking:

But that is not the case (kind of). Let me explain. Kids are fussy. It's a fact of life. So sick children are especially fussy (by "children" I more accurately mean this 11 month old.) I was working with another medical student who was trying to listen to this child's lungs. The child was unhappy and crying. Let me tell you, it's hard to hear breath sounds when they're being dominated by loud wailing. To help with this, I pulled my ID badge (clipped to my white coat on a retractable...badge...clip) and was loosely holding it in front of said screaming child to function as a distraction.
This is what I'm talking about. Although mine isn't FBI. Sadly.

It worked. Seriously. It often does. The kid starts playing with the badge, and boom, no more crying. Unfortunately, the aforementioned retractable badge clip felt that now was the most opportune time to become UNclipped from my white coat. This resulted in it rocketing from my hand and hitting the first thing in its path...

...the kid's face.

A reenactment of what may have happened.

I know! I know! I'm a terrible person. Needless to say, I went ahead and left the room at that moment. The boy was unhappy and me being within sight of him wasn't going to help. In my defense, however, it was the card and not the heavy retractable part that hit him. When it was all said and done he was alright and not worse for wear.

Kid's are resilient, right? Especially in the facial...region.

Until next time.

Ongoing Changes

If you can't tell, I'm in the middle of shaking somethings up around here.

You may or may not have noticed if you came here from a bookmark or previous address, that there was a feeder page and my blog has a new URL. If you're currently going, "What are you talking about?" you can pretty much ignore what I am, in fact, talking about. I originally wanted my blog to be orderly and systematic in its makeup. That flew out the window when my desired address, to match my desired title, "Paging the Doc," was not available. This led to the use of the alternate address -pagingdocgib- that you know and love (or maybe just bookmarked). Imagine my delight when I discovered my ideal name, that which so perfectly captures the essence of my writing (or maybe just the title of my blog), was available. I snatched it up!

So what does this mean for you? Nothing if you don't want it to. You can go to pagingdocgib.blogspot and be redirected here (although you will no longer see new posts in feeds/notifications), or you can do what the cool kids are doing and delete that old mismatched bookmark and save yourself a new new. The choice is yours. Choose wisely.

"But MG," I hear you -faithful reader- calling, "What about a real update?"
Well. If you insist.

From where we left off, I have now successfully finished my first year of school and am currently doing some summer work in Pediatrics. Let me repeat that.

I HAVE FINISHED A YEAR OF SCHOOL.

This is also known as, Good-lord-how-did-time-go-by-so-quickly or I-don't-feel-like-a-quarter-of-an-official-doctor. Other milestones? I have also now been married for over one year and, as expected, lived in a new city/apartment for the same amount of time. I cannot believe it.

The summer work in Pediatrics is going swimmingly. I have really enjoyed getting to see how the hospital system works, met some really interesting and fun patients, and its nice to see if I might want to do Peds for real. You know, when I'm done in 3 years (=insane.) The most amazing part thus far? Just how resilient and upbeat children can be. Some of these patients have acute problems that will be done in a week, others have lifetime chronic illnesses that will put them in and out of the hospital every year or six months, but all of them are so joyful and happy. They really add perspective, in the best possible way. Sometimes it's been heartbreaking, yes. But overall? I wouldn't change a thing.

Well. One thing. That my own sinuses would obey me and stop acting out so that I could be at the hospital now, rather than at home, seemingly blowing my brains out through my nose. I haven't had anatomy of the head yet, but I'm sure there's some kind of pathway/condition that could make that possible.

Until next time.

What Really Happened

So everyone is clear: this post is my response to the LOST finale and frustrated place to vent about how some people just don't seem to get what happened.

So: if you're a LOST fan- SPOILERS.
If you're not a LOST fan- sorry, this blog will suck.

Begin rant:

Did other people just not get it? People seem to think that the characters were dead all along, or there was no plane crash, or they all died when the nuke went off, or that the island was purgatory. No, no, no, and no!

The island is/was decidedly NOT limbo or purgatory. As Christian (Jack's father) said, everything that happened in life and on the island was real. The plane crashed, the oceanic 6 went home and went back, everyone time traveled. All real. Jack fixed the Well of Life, that last bunch of people got off the island, and Hurley/Ben took over guarding it. Jack died on the island. All real. Thinking anything else is simply not understanding what happened on the show.

The ONLY THING that was them being dead/in purgatory was the sideways world that we STARTED TO SEE after the bomb went off at the beginning of the season. In "real life" the bomb exploded, brought the characters into present time, but the island/life never "reset." The writers simply started showing us the sideways purgatory world at the same time.

"What was the point of the sideways world?" you ask.

It allowed the show to essentially give us, the viewers, half of a season of character resolution. Having the sideways world be the characters post-death was perfect. It allowed us as viewers to see what each character truly thought of themselves at their core and then reconciled those feelings with the happenings and conflicts of the tumultuous lives they had with each other on the island. We got to see Sawyer be the good man he knew he could be and always wanted to be as a cop in LA. Jack became the father and family man he never had. Kate was no longer a murderous fugitive, but an innocent fugitive. Locke lived a life where he loved others and, most importantly, loved himself without feeling shorted for being in a wheelchair.

The characters being "touched" (by Desmond or otherwise) and remembering each other was them remembering their REAL LIVES and being able to then grow and move on (which is what happens in purgatory). How could it get any better?! Ben stayed outside the church because he was not contented with himself and the life he led, hence him not moving forward. People you didn't see in the church? All people who had either moved on individually (as I suspect Richard had- he knew what he wanted- his wife) or weren't ready yet, such as Daniel Farraday and Charlotte (this is what Desmond and Eloise were discussing at the concert. Desmond was not "taking" Daniel because he wasn't ready).

((Fun Did-You-Remember Moment: Sideways (aka dead) Jack looks in the mirror and asks his mother where he got that scar on his abdomen because he doesn't remember. She says he had his appendix out. We know better than that now. StabbedbyFakeLockeduringtheEpicLastBattletoSavetheIsland.))

The only people who will be truly upset are the ones who don't understand what happened (but now hopefully they do with my explanation) or those who do not accept that the show is about the characters more than the mysteries (which it always has been). People will ask about Michael/Walt and other characters, or other mysteries on the island (the numbers- etc), but I respond: we KNOW answers for most of them and for the others- who cares? Will it make any difference knowing those details? We know Michael has become a "whisper" on the island- which is what happens to people who die on the island but are not finished. We can assume Walt has gone on to lead a normal life. The numbers relate back to Jacob's master plan of bringing the candidates to the island to save and protect it. They stem from the lighthouse, as each candidate had a number (1-108). 4,8,15,16,23,42 were the numbers of Locke, Jack, Sawyer, Hurley, Kwans, etc.

It comes down to this: Did you enjoy watching a thought-provoking, well-made program, that is and will be different than anything on television?

For me that answer is a resounding YES. Well done. Fantastic finale.

Thoughts? Comments?

End Rant. End of LOST. Sad face :(

Until next time.

A Return to Form?

With the point of this blog being to keep me writing, it would probably be more effective if I actually wrote something once in a while instead of posting comics.

I'm rather taken aback by the fact that it's almost the end of April. I cannot believe that the school year is nearly finished. No small amount of disbelief hits me when I ponder the fact that I'm almost a quarter of the way through my medical education. Well, let me clarify: I'm a quarter of the way to being a doctor; I'm nowhere near close to even remotely thinking about the end of my medical education. I'll probably finish my schooling when Winston, my faithful and inquisitive T-Rex, finally stops questioning every aspect of the world.

Read: Never. His curiosity is insatiable!

Side-Note Medical Reminder: Ladies- do a self breast exam once a month. Fellas- same goes for you with your testes. Seriously. I'm not kidding.

At this point I would like to remind all of my faithful readers that medicine can be gross and you should consider yourself warned. The following isn't a detailed description of a random medical procedure or graphic photo, just my musings on the poor word choice by those in medicine. Examples are, however, given.

The terms that people in medicine use to describe different aspects of things that can go wrong with your body disturb me sometimes. In addition to using food-words such as caseating (from the latin caseus meaning cheese) to paint the delicious image of dead and decaying body tissue onto the blank canvas of your imagination, the particular description that currently gives me the creepies is- wait for it - "like a bag of worms." This line of text would be where I normally delve into all of the medical details none of you find particularly interesting. Instead, I think a more fitting option is to simply let that phrase- like a bag of worms- float around, wafting in the air while you silently shudder and try to imagine what it could be used to describe.

(If you really must know, it describes the widening and dilation of veins that run from a man's testis- aka Varicocele. Not awful or really even that disturbing. It was just more fun to portray it that way.)

Until next time.

The Beginning of the End of the Beginning

This just might be the current feeling. Or at least the one that seems to crop up right at the end of any breaks.

(Click for better view)

Thoughts?


Until next time.

A Different Type of Battle

You wouldn't think that multiple choice exams could be that intense, right?

(Click for a better view)

I'm thinking of doing more drawings. Thoughts?


Until next time.

Health Reform? Huh?

If you find yourself asking the above question, look no further.

Well, look further if you'd like, as I'm only posting my summary, but the info is pulled from both my school and the Kaiser Family Foundation (a great resource for impartial info- I recommend it over any news-media sources).

I'm going to outline what's up and then give my brief opinion of the situation for those who are interested. More extensive information will follow after my opinion. It should be a pretty good outline as to what's going on as of today. (Certain things might change if the reconciliation package passes the Senate- namely the removal of special preferences for specific states and a restriction on the proposed minor tax on really wild insurance policies.) Let's go!

What's going to happen change right now? These things will happen in the first year.

• People who are currently deemed "uninsurable" due to preexisting conditions will be able to enroll in a new federal insurance program that should be established in 90 days. This will serve to kind of get the ball rolling until such conditions are banned outright for adults in 2014.
• Children under 19 cannot be denied covered due to preexisting conditions. Parents will be able to continue covering their children on their plans up until the age of 26 (unless they are offered insurance through their employer). This helps give kids access.
• The Medicare Part D Coverage Gap (the giant "doughnut hole" in coverage for drugs for the elderly) will be halved, with 50% being covered (up from zero). This helps fix a huge cost issue in providing pharmaceuticals to the elderly. Fun fact: Want to know the quality of the legislation that made Part D coverage, passed in 2006, so awesome? The main proponent of the legislation and head of the committee on pharmaceuticals, Former Congressman Billy Tauzin (R-LA), quit Congress two days after it passed and then immediately started working for the PhRMA lobbying group. Insane.
• Small businesses (less than 25 employees/wages of less than $50,000) qualify for a tax credit of up to 35% of the costs of health insurance premiums for employees.
• No more lifetime caps on insurance coverage and restrictions will be placed on annual limits.
• Insurance companies not cancel coverage retroactively except in cases of fraud.
• Increased government oversight of insurance costs and overhead. Companies must report how much they spend on medical care against administrative costs.

Fast Facts

- Everyone will be mandated to have health insurance. To help with this, insurance subsidies will be available to individuals making $14,404 to $43,320 or families making $29,326 to $88,200. People below these ranges already qualify for coverage through Medicaid, or if old enough, Medicare. The subsidies would be given on a sliding scale. If you already possess insurance through an employer or group, nothing changes. You keep your insurance and continue as usual.

-If you do not purchase insurance, you will be fined. It is $95 dollars for an individual, starting in 2014, and increases to $325 in 2015, and $695 (or up to 2.5% of income) in 2016. For families, the maximum would be $2,085 in 2016, however, people can be exempt from this fine because of financial hardship or if they are Native American (and thus already provided with a degree of federal health insurance).

-Preventative health care visits, regular check ups, and many cancer screenings can no longer have a co-pay and will be free in some cases.

-The Medicare payroll tax of would be raised to 2.35% (from 1.45%) on individuals making more than $200,000 a year and couples making over $250,000.

-The reform is estimated to cost $940 billion dollars over the course of a decade. However, with all of the changes being made, the reform will actually decrease the federal budget deficit by $138 billion over the same decade. In addition, it is estimated to reduce the deficit by ~$1 trillion over the second decade.

My Thoughts?

Very briefly, I think that the bill will do much more good than harm. It extends coverage to people who need it while adding regulation and changes to the industry that will help make it more viable for the future and help the national economy (Health care is currently ~16% of the GDP and rising, that needs to change. In comparable countries it's less then 10%). I get frustrated with people who want something that is XYZ-more liberal or ABC-more conservative. To me, and I view this as being more practical, the question must be if this is the best step in the right direct that we can take at this moment? Does it lay the groundwork for things being better both now and in the future?

In my opinion, belief, and thoughts, it does. The reform does not murder Liberty or kill Freedom. The Constitution is still intact and well. We are not becoming a crazed totalitarian nation and this doesn't set us on that path, or close to it; such notions are nothing more than the rantings of those trying to make money or short-term political capital, preying on fear and appealing to the extremes.

Nothing will ever be perfect. Remember, the object is to form a more perfect Union. I think this qualifies as more perfect than what we have now.

Your thoughts?

P.S.- Want more info? About how this affects things in the industry? Here's some summary:

HOSPITALS: "The hospitals are ultimately the winners — one doesn’t increase spending on health care by nearly $1 trillion without some significant part of it flowing to hospitals," said Sheryl Skolnick, a hospital analyst with CRT Capital Group in Stamford, Conn.

· Pros:

o Worried they might get hit hard by the health legislation, hospitals were the first industry to make a deal with President Barack Obama and the Senate Finance Committee last year. Hospital groups agreed to give up $155 billion in Medicare funding over the next decade. But they are expecting that to make more than that – at least $170 billion - by having to treat fewer uninsured patients.

o An individual insurance mandate and subsidies for low-income Americans to buy coverage means hospitals will have more paying customers.

o Hospitals got guarantees that cuts in federal Disproportionate Share payments that they receive for treating the uninsured wouldn't occur until the insurance expansion is in place. And even then, some of the funding will remain to help hospitals treat illegal immigrants and recipients of Medicaid, the state-federal program for the poor.

· Cons:

o Hospitals are slated to lose $155 billion in federal funding over a decade.

o A new independent commission would have broad authority over Medicare spending, though most of its powers don't kick in until 2018.

· Mixed

o The bill sharply expands Medicaid, which will reduce the number of uninsured patients. But Medicaid typically pays less than private insurers or Medicare.

INSURERS : In the short term, insurers will gain enrollment but the bill may cost them in the long run if health costs don't come under control," said Peter Kongstvedt, a McLean, Va.-based insurance industry consultant.

· Pros

o The individual health insurance mandate, along with subsidies for low-income Americans, will bring insurers tens of millions of new customers.

o The expansion of Medicaid will also provide new customers; many recipients will be covered by private managed care plans.

· Cons

o The bill calls for $132 billion in cuts to Medicare Advantage plans, the private health plans that cover one in five seniors (only one in ten seniors in Kansas).

o New taxes on the industry total $70 billion over 10 years, beginning in 2014.

o Insurers are facing a new requirement to spend 85 percent of their premium dollars on health care, potentially leaving less money for administration, marketing and profits.

o The so-called "Cadillac" tax on high-cost health plans is aimed at insurers, though it won't take effect until 2018.

o Lawmakers called for relatively low penalties -- just $95 in 2014 – for not buying insurance, which could encourage many healthy people to skip coverage.

PHARMACEUTICAL COMPANIES: "Pharma is one of the big winners," said Nancy Chockley, president of the National Institute for Health Care Management, a nonpartisan health policy research organization funded by Blue Cross and Blue Shield plans and government grants.

· Pros

o The drug industry will put up $84.8 billion to help fund the legislation. Part of that goes to making brand-name drugs more affordable for seniors who hit the Medicare coverage gap - the "doughnut hole." But pharmaceutical firms stand to make much more in return. With more Americans insured, more can buy brand-name drugs.

o Expensive biologic drugs would get 12 years of exclusivity protection from generics. Obama, AARP and the generic drug industry were calling for a 5- or 7-year limit. While biologic drugs are only a small portion of industry sales, they represent the fastest-growing segment of the market.

o The legislation, despite the pleas of some lawmakers, doesn't make it easier for Americans to buy less expensive drugs from abroad. Nor does it allow the government to negotiate lower drug prices for Medicare.

· Cons

o The industry will pay out $84.8 billion in new fees, rebates and discounts over the next decade.

DOCTORS : "Primary care doctors got a bump up in funding and overall doctors got a pass," said Gail Wilensky, a senior fellow at Project Hope and former head of the Medicare program.

· Pros

o Primary-care doctors and surgeons practicing in areas with a shortage of physicians get a 10 percent bonus payment from Medicare from 2011 to 2015. Medicaid will pay primary care doctors Medicare rates in 2013 and 2014, to coincide with the Medicaid expansion. Medicare typically pays at least 20 percent higher rates than Medicaid.

· Cons

o No significant medical liability changes are in any of the overhaul bills, though there is money for states to run pilot programs.

· Mixed

o The Medicaid expansion, to everyone under 133 percent of the federal poverty level ($29,326 for a family of four) means more patients have insurance, though at the lower Medicaid rates.

o The current Medicare physician payment formula that each year threatens to slash doctor payments was left untouched. But Congress traditionally steps in to nullify the cuts.

NURSING HOMES: Because most nursing home patients are covered by Medicare or Medicaid, reducing the number of uninsured doesn't really help the facilities. As a result, the industry doesn't see much gain in the overhaul.

· Pros

o The bill would establish the Community Living Assistance Services and Supports (CLASS) Act, a national voluntary insurance program that would allow people to finance their long-term care in advance through payroll deductions. It would provide a cash benefit of about $50 a day for long-term care, including nursing homes, in the home and adult day care.

· Cons

Nursing homes would see their Medicare reimbursements cut by about $15 billion over the next decade. While Medicare comprises only about 13 percent of nursing home revenue, the industry relies on the money to offset low Medicaid reimbursement.

Must Be Done

UPDATE: Victory. Check out the facts here. Rock Chalk.

In honor of the game tonight, I post a reminder of the last encounter and follow with a preview of what's to come this evening.

Reminder:


Preview:

I fully expect this to be a good and challenging game. My desired outcome is slightly obvious.

Rock Chalk.

Let's Be Realistic

Edit: Bonus about the proposal I mention? It's only 11 pages long. Concise!

For right now, I just don't have the time to finish my giant post on health care. I'm sorry and I'm sure you're all weeping at the news, but you'll handle it. So where do we go from here?

Not far. Today, the White House released their recommendations and outline for a revised health care bill to be agreed upon by the Republicans and Democrats at the upcoming televised meeting on the 25th. So what's happening now? Well, here's an article and I've included a summary. Considering the current progress of our Congress and the circus with everything, I think it'd be great if we could pass this.

Outline:

• The secretary of health and human services would work with a seven-member board of doctors, economists and consumer and insurance representatives to review premium hikes. This Health Insurance Rate Authority would provide an annual report to recommend to states whether certain rate increases should be approved, although the secretary could overrule state insurance regulators.

• New health insurance subsidies would be provided to families of four making up to $88,000 annually, or 400 percent of the federal poverty level. Compared with the Senate bill, Obama's proposal lowers premiums for families making between $44,000 and $66,000, according to the White House. Compared with the House legislation, it lowers premiums for families making between $55,000 and $88,000.

• A 40 percent tax would be imposed on insurance companies providing so-called "Cadillac" health plans valued at more than $27,000 for families. The tax would kick in starting in 2018 for all plans. In contrast, the Senate bill would apply the tax to plans valued at more than $23,000 for families. The House bill does not include the tax, which labor unions vehemently oppose.

• Health insurance exchanges would be created to make it easier for small businesses, the self-employed and the unemployed to pool resources and purchase less expensive coverage.

• Total out-of-pocket expenses would be limited, and insurance companies would be prevented from denying coverage for pre-existing conditions. Insurers would be barred from charging higher premiums based on a person's gender or medical history.

While I post this and get back to learning about PUD, let me know what you think.

A Complex Situation - Part 1: Politics

UPDATE: I really am going to post parts 2/3. I promise. School has just swamped me and I'm not sure when I can sit down and devote the time I want to present everything clearly. Until then: why not leave or check out the comments?

NOTE: This discussion will need to be split into multiple blog posts. There's just too much information for a single one. The discussion will most likely be divided into the categories of Politics, Insurance Companies, and Philosophy. Don't worry; I'll cover everything that everyone commented about.

I think that my title pretty much defines the current state of health care. If you're just joining in on this little session, I highly recommend that you read the very different opinions and views expressed in the comments of this post as I'll be summarizing and referencing peoples thoughts here.

Looking at each person's response, the reason for debate/fighting/disagreement pretty much slapped me in the face. Out of the six of my friends that commented, each brought up different issues, concerns, and possible solutions. Now think about how we have 300+ million people in our country . Yikes. No wonder people are heated about things.

The common fact that everyone acknowledged: something needs to change. No one thinks that our status quo should be maintained. Health care needs to change.

So, I've decided to make the discussion more manageable by breaking it down into the subcategories of (I think) Politics, Health Insurance, and Philosophy. I'll try to pull points from each person into the category where it most fits for my discussion/presentation. Don't worry if you think I've missed something right now as I'll likely bring it up in one of the following posts. Where possible I'll link/cite facts that I've learned. Let's go!

First up: Politics.

-Caleb said the predominate issue is the "time in which to revamp" health care and that he thinks Democrats are trying to rush things through to bolster political power. Instead, the process should slow down because it is "affecting everyone...not just the deaf Democrats in power." He thinks "that Obama's tactic of "we must pass everything now, no questions asked" is dishonest and insulting."

-Tyler talked about how the US is behind Europe in health care standards and that if "legislation allows some Americans a higher quality of life, but is an imperfect plan, it is worth it." The final goal and objective should be to "improve quality of life." [Side note: the US ranks 37th in the WHO rankings from 2000 (most current) and yet we by far spend the most money]

-Kevin said the government shouldn't have access to medical records or "the right to determine, based on set criteria and yes/no symptom check sheets, whether or not an individual receives medical care." He also thinks the government should "slow down when developing a new system of health care" because it's often a flawed design and concept of an idea that leads to problems and failure. The role of government, and politicians, is to analyze the situation and revamp healthcare "for the fulfillment and benefit of the majority," because "legislation passed without adequate consideration for the people fails."

-Megh talked about how she thinks health care should be free and paid for through taxes because anyone can get sick at any time, but acknowledged that the US will likely never have this reform due to the financial stakes of large companies. She also linked an article that spoke of the need for Democrats to maintain their push for legislative reform despite the short-term implications it may toward re-election.

My Thoughts?

First, I take issue with the idea that the problems of healthcare reform are somehow the individual fault of either the Democrats, Republicans, or the Obama administration. In my opinion, if blame were to be assigned it would fall at the feet of Congress, both Left and Right alike.

As previously stated, most everyone agrees that the country seriously needs reform. Sadly, the big problem of passing/not passing any legislation is not because of the differing views of the political parties but instead the issue of politicking. Both parties have become so obsessed with winning and being correct that the legislative process has ceased to function. Democrats in Congress, feeling jilted from decades without full political power (holding both Congress and the Presidency), seem to occasionally feel the need to flex their power over the GOP and not compromise. This could be really bad if someone wanted to compromise. Republicans, upset about this and their lack of a cohesive party theme/identity, have essentially stuck their fingers in their ears, tucked their head, and hoped that Democratic failure=Republican success. You have one side attempting to enact some kind of payback and the opposing side trying to not do their job and hope that it leads to being re-elected.

This is no way to run a country.

Kevin said it best in his comment, explaining that we

"elected them [Congresspersons] to make decisions not necessarily based on their goals or ambitions but based on our [the citizens'] situation and needs. It is their job to view the current national and global situation from every possible angle. It is their job to make sense of things and then approach the problem with the goal of improving the lives of those they serve."

I think most everyone in the country would agree with that. We need less politicking, fighting, bickering, partisanship, and worrying about the next election and more cooperation and accomplishment. How does this play out in health care and with the reform that is being debated now?

Like most everything about health care: it's debatable. The current bill is HR 3590- Patient Protection and Affordable Care Act (that's the FULL TEXT- you won't read it). There are also quick summaries from the Democratic and Republican parties. As an overview, the bill would reform/regulate circumstances for physician malpractice, prevent insurance companies from denying coverage to anyone with a preexisting condition, expand health insurance coverage to the ~40-60 million uninsured Americans (I quote a range because we learned how about each year millions of people lose/gain coverage; it's a cycle), offer a federal pool for those without insurance to buy into, and require everyone to have health insurance (much like mandatory auto insurance). This would be paid for through taxes on individuals making more than $500,000 a year (actually repealing an old tax cut), people with really ornate health plans now (I refuse to use the name of a certain car brand), and through cutting/reworking existing programs and funds. It is estimated to cost ~$850 billion total over the next 10 years, but actually result in a ~$150 billion deficit reduction over that time.

Now most people see those things, having heard about them in the news, and go "Whoa, those are all the things the Democrats want. None of the Republicans want that." To that I reply: not exactly. Surprisingly, that reform is actually more of a centrist option. Many people who are far left or far right would prefer something different (a single-payer and completely private system, respectively but they'll be more of that later, under the Philosophy post). HR 3590 actually isn't that different than the current Massachusetts health care system, signed into law in 2006 by Republican then-governor Mitt Romney.

Now, I know that's a lot of information but sadly it's really just a quick overview of the current situation. Don't worry, I'll present a discussion/reasoning of the various different types of health care systems during the Philosophy post while going through more comments. The gist of all this? Congress, meaning both political parties, need to cut the crap, do their jobs (meaning make the necessary changes to fix the country), and stop worrying about their own job security.

Lastly, and this is more of a detail, I don't think Obama can be blamed for allegedly pushing reform through too quickly or- and I'm paraphrasing- for playing the urgency card too much, simply because he does not set the pace. (All of this assumes one thinks things are going too quickly.) The president's role is to set the agenda. A pillar of Obama's campaign message was health care reform; it makes sense to me that he would be calling for Congress to tackle such legislation (not to mention it makes up ~14-17% of our economy). The reform itself and its timing is an issue of Congress and their responsibility to write and pass.

Personally, I don't think that there is ever going to be a "right time" to work on health care reform or any big issue for that matter. Don't get me wrong, I want things to be well thought out and done right, but health care reform is not a new issue. FDR, Truman, Johnson, Nixon and Clinton have all attempted comprehensive health care reform. Only Johnson succeeded (partially) with the creation of Medicare and Medicaid. (Fun fact: FDR was going to propose socialized medicine until a certain country had to go crazy with that whole whacked-out-final-solution-socialism-world war thing. It's in this book which I've recommended before.) With the current political environment of every action being analyzed through the prism of the next election and everyone too worried to simply do the job they were hired for, I'd rather Obama make it a national issue (thereby doing his job) and try to get Congress to finish it.

Still with me? If so: more to come later.

Until next time.

*While I don't think it's a fair way to describe any of my readers, Glenn Beck is probably certifiably insane and terrible for our political process. Regardless of political views.