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The Greatest Document Ever signed

I sometimes wonder what the world would be like today had that document not been signed. City life would be like living in the 1800s, and we would still be riding around in horse and buggies, living amid dust and horse poop and the bugs and rats that come with it. And a world far more polluted than it is now because we wouldn't have the technology to clean it up as much as we do now.

Sure we have pollutants in the air today, but without modern technology, we may not have the scrubbers in coal factory chimneys to filter out most of the crud. Human feces would still be a problem, as toilets may never have been invented, let alone the ability to purify this crud and keeping it safe for our water supply.

Instead of having clean drinking water, we'd be drinking water which is a breeding ground for diseases, and we would not have the know how nor the technology to fight these diseases.

As the worlds population grew, and industrial factories, coal burning would have accelerated with no fear of global warming as the current activists wouldn't have the time to be active, as they'd be working to survive as people did in the 1800s. People had far less luxury time in the primitive world as we do today.

Smoke would be billowing from the growing number of homes, and this would far exceed the pollutants we have in the air today, because there would no contraceptive devices to allow families to control the number of children they have, and there would be no population control.

There would be less sanitation, and the ability to fight diseases may never have been discovered. Polio would have ripped through the world, and would be scientists would still be working on their primitive farms instead of having the time to invent and discover.

Sure there probably wouldn't be the prevalence of COPD and asthma as there is today, because the sky rocketing rates of these diseases are often theorized to be the bi products of the modern, clean world we live in. And life expectancy would be primitive as well, decreasing the need for long term nursing homes and longevity.

Diseases like Alzheimers and Parkinsons never would have become an issue, as these diseases are the result of longevity for the most part, a longevity that may never have arrived.

There probably would still be hospitals, but the use of oxygen may not have been as huge as in the post WWI big boom in cigarette sales era and rise in lung cancer and COPD. People would still get pneumonia and other lung diseases, but the era of discovery may never have arrived. Many of these disease infested people would simply suffer and die in their homes.

Food would be less safe, as we may never have invented quality assurances to guarantee safe foods. Likewise, we may never have invented pesticides and chemical fertilizers that provide us with an abundance of safe foods.

Even the poorest in America today can afford to buy fresh produce from a local market. And those who can't usually can get fair government assistance to do so. Would it be this way had Ben Franklin persuaded other members of the 2nd Continental Congress against signing that document.

The ABG machine and other lab machines so importatnt to the medical field may never have been discovered, let alone the ability to know what pH, CO2 and PO2 or hemoglobin is. The hypoxic drive theory that drove this profession for its first 50 years would never have been concocted, let alone disproven. That type of deep research would be left to a far fetched country with a booming economy to afford such luxuries.

The iron lung would have remained a pipe dream, let alone the sophisticated technology that exists today to allow people a chance to get over the hump and live another 20 years. And, any babies born with diseases, or too early, would have no chance of surviving.

People complain today about how bad we have it. I hear it every day. I hear people wining because they have to wait too long for the Internet, or wait too long in the emergency waiting room, or wait to long for their pain medicines. I can't help to think when I hear these people that they are taking what they have, what we have, for complete granted.

They do not think that millions have died to allow us the luxury time to complain. They died to give us the freedom to cry out that our president isn't doing enough to fight global warming. They complain that technology is destroying the planet, while at the same time scientists are working hard to improve technologies to make a cleaner and safer world.

These people never thank God for Ben Franklin and Thomas Jefferson. They never thank God that new technologies have actually made the world cleaner and safer. They never thank God when progress is made. And lots of progress has been made.
Sure there is a ton more progress to be made, and concern for the environment, concern for slow emergency rooms, is needed. Without concern there never would be progress. My dad always said, without complaining lazy people nothing ever would be invented.

He may have been right about that. But without that founding document, the know how and the technology may never have come about for these lazy complainers to invent and discover with. Let alone, since the economy never would have boomed, there would be little time to be lazy nor to complain.

Why? Because it is the wealth that has been derived as a result of American freedom, American capitalism, that has made us lazy, and gives us the ability to complain, the ability to be concerned for the sick, for the poor, for the lazy complainers.

So, what we have in this world is pretty darn good compared to what life was like even 100 years ago, let alone on those hot, musty, bug infested days when the founding fathers had to lock themselves in a burning hot room with the windows shut so no onlookers would hear what they were talking about...

...while they wrote their document free hand instead of on a word processor.

Furthermore, most people born with diseases like myself never would have made it out of childhood. So perhaps disease would be the one population control we'd have. Yet, population would not be a concern to environmentalists, as they would not exist in this alter world.

So we should all take the time not just to celebrate the 4th of July, but to really think for a moment how great we have it compared to our forefathers, and compared to other nations where freedoms do not exist.

Happy 4th of July.

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Yet another example of what's wrong with healthcare

It was kind of a culmination of all I've written about on my blog the past year was when our hospital Quality Analyzer came into the office and said, "I need to speak with Rick."

I spun around my chair and said, "Hi, Gerri, what can I do for you?"

"I was just wondering if you gave any breathing treatments to the kid in 310 today?"

"Um," so what was the right answer? The truth perhaps?  The kid in 310 was admitted with croup yesterday and was ordered to get racemic epinepherine breathing treatments prn. After an awkward moment of silence I settled on the truth.  "I didn't give one."

"Oh, I was hoping you did one and forgot to chart." She smiled. "The patient was discharged and now his insurance is refusing to pay for today because we didn't do anything today. If you did a treatment..."

"Do you want to to go in and chart a treatment I didn't do so we can get paid."  A provided her with an eerie smile.

She gave me the thumbs up.

Of course she was joking and so was I. Yet this is a perfect example of what is wrong with the healthcare industry. A patient needs to be admitted for observation, and yet because we didn't do anything the patient's insurance won't pay.

"Well," I said, "I guess for now on we'll be giving Q4 breathing treatments on all of Dr. Kipper's patients."

"Sure thing," she said, giving me the thumbs up signs again.

Dr. Kipper was new. The other pediatricians had already learned to order Q4 ventolin and racepic epi prn. That order makes no sense medically, and is a complete waste of time and money and results in RT apathy.

Yet that person sitting in a chair in Washington who makes all the laws was smiling somewhere in a leather chair in Washington as she unwrapped her paycheck.

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Yet another example of what's wrong with healthcare

It was kind of a culmination of all I've written about on my blog the past year was when our hospital Quality Analyzer came into the office and said, "I need to speak with Rick."

I spun around my chair and said, "Hi, Gerri, what can I do for you?"

"I was just wondering if you gave any breathing treatments to the kid in 310 today?"

"Um," so what was the right answer? The truth perhaps?  The kid in 310 was admitted with croup yesterday and was ordered to get racemic epinepherine breathing treatments prn. After an awkward moment of silence I settled on the truth.  "I didn't give one."

"Oh, I was hoping you did one and forgot to chart." She smiled. "The patient was discharged and now his insurance is refusing to pay for today because we didn't do anything today. If you did a treatment..."

"Do you want to to go in and chart a treatment I didn't do so we can get paid."  A provided her with an eerie smile.

She gave me the thumbs up.

Of course she was joking and so was I. Yet this is a perfect example of what is wrong with the healthcare industry. A patient needs to be admitted for observation, and yet because we didn't do anything the patient's insurance won't pay.

"Well," I said, "I guess for now on we'll be giving Q4 breathing treatments on all of Dr. Kipper's patients."

"Sure thing," she said, giving me the thumbs up signs again.

Dr. Kipper was new. The other pediatricians had already learned to order Q4 ventolin and racepic epi prn. That order makes no sense medically, and is a complete waste of time and money and results in RT apathy.

Yet that person sitting in a chair in Washington who makes all the laws was smiling somewhere in a leather chair in Washington as she unwrapped her paycheck.

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Basketball and Feelings Skills

Several boys were playing basketball outside their residential dorm. Marcus made a basket despite Jeff’s guarding him. Jeff began to taunt Marcus, saying the basket was luck, he didn’t know how to play, he was too short and too ugly. The insults expanded to include racial slurs and comments about Marcus’ mother. Marcus was flustered and missed his next shot. Jeff started to laugh. Marcus went over and punched him, hard. The staff stopped the game and brought the boys inside. Marcus and Jeff were bother restricted, and Marcus’ punishment was seven days of unit restriction because he had used physical violence.

This incident happened at a place I was training. This provided a great opportunity to put these theories into practice.

There were many men in the training, all shapes, sizes, ages, and races. I asked the men to consider that they were in a pickup basketball game with some friends and someone started insulting them, including using racial slurs. I asked for a show of hands of those who thought they could get through this situation without hitting anyone. All the men raised their hands. I then asked what they would do. Their answers included:

I would just stop the game and walk away.

I would say “hey, man, stop talking like that.” And if that didn’t work I would stop playing.

I would play better and better and wipe the person out in the game.

I would use that event as a reason to practice and make my game better.

I would remind myself that this was not very important; it’s only a game, who cares what he says.


Then I asked: what would you have to know, believe, or be able to do in order to respond like that?

After some discussion these ideas emerged:

You’d have to be confident enough of yourself not to take his words to heart.

You’d have to know you were getting upset and have some ways to calm down.

You’d have to have other good things in your life, other friends, other skills in order to know that this game was not that important and that it did not represent all of who you are.

What we want for these kids, what we are trying to achieve, is that they become these men. The taunts will always be painful. Anyone would be upset. But we want them to have what these men have- the skills that enable them to walk away and not hit someone.

And we also want to think about Jeff- how can he learn to handle someone else’s success or maybe even lose a game without resorting to racial taunting? Both the taunting and the hitting come from the same place: a deep feeling of inadequacy that results in this small game feeling like a measure of total worth.

So what will develop these skills? How can we increase confidence, self awareness, an ability to notice and modulate your own feelings, and the ability to turn bad experiences into motivation? Unit restriction will not accomplish any of those things, in fact may decrease some. Instead, if the boys do something constructive together (maybe raise money for some new sports equipment?) they will discover that relationships can be fixed, and that they have something to contribute to the world- whether or not they can always make a basket.
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Is an 1800% price hike justified?

So tell me what's wrong with this picture.  There's this medicine called projesterone that is used by OB/GYNs as a medicine to make the pregnancy last longer.  It's generally used to prevent pre-term labor in moms who have a history of early pregnancies.

This medicine is given once a week to accomplish said goal.  The neat thing is no study has ever been done to prove that it works.

Now in the past the injection cost $10 dollars, and it's given after 5 months.  So that comes to about 20 injections if the pregnancy goes to term.  So at this price, it was worth the cost.

Yet this medicine has since been patented, and now the medicine costs $1,800 for each injection.

Now I like patents because it gives companies and people an incentive to take the financial risk to find new products.  Yet this price hike seems a bit steep.  What do you think.

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Is an 1800% price hike justified?

So tell me what's wrong with this picture.  There's this medicine called projesterone that is used by OB/GYNs as a medicine to make the pregnancy last longer.  It's generally used to prevent pre-term labor in moms who have a history of early pregnancies.

This medicine is given once a week to accomplish said goal.  The neat thing is no study has ever been done to prove that it works.

Now in the past the injection cost $10 dollars, and it's given after 5 months.  So that comes to about 20 injections if the pregnancy goes to term.  So at this price, it was worth the cost.

Yet this medicine has since been patented, and now the medicine costs $1,800 for each injection.

Now I like patents because it gives companies and people an incentive to take the financial risk to find new products.  Yet this price hike seems a bit steep.  What do you think.

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One cigarette can cause lung cancer

Show your kids this study, because it provides the proof you need that even just one cigarette can start to cause damage to your genes that increase your risk for developing any of the following:

  1. Lung cancer
  2. Heart disease
  3. Stroke
  4. Emphysema
  5. Infertility
  6. Alzheimer's disease.

The study, completed at the University of Minnesota, shows that even after as little as 15 minutes of smoking a cigarette the human body starts to metabolize harmful substances --polycyclic aromatic hydrocarbons s (PAH). The resulting molecules can cause DNA damage that can lead to any of the above,  particularly cancer.

The DNA mutation caused by smoking just one cigarette is permanent, and increases your risk for developing lung cancer.  Cigarettes can effect your DNA really fast, and this includes both cigarette smoke from both 1st and 2nd hand smoke.

Differences in the way our body's process PAH may help researchers understand why some people who smoke develop cancer and others do not.

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