Friday, June 6, 2014


I was going to jump in to the conversation in the locker room today but couldn't.  One of the other docs was on a rant.  He had just removed the second infected valve of the heart of a young IV drug abuser.  It went something like this.  "Evolution is BS! You don't see animals evolving into  species that grow some plant only to grind it up, mix it with water, boil it and inject it into themselves.  Then in a stupor fall out of a tree only to have other animals drop everything to save them, support them, rehab them, and then pay for them to go out and do it again!"


I think I am just going to give in and file for Medicare Disability for writers cramp, trigger finger and depression.  In addition to all the other forms, there is now a new plethora of other forms that must be filed out for Medicare compliance according to JACHO, CMS and WGF. (WGF is "who gives a +++!")  I didn't even have clinic today and only had to round on a few patients but still I had to sign, time and date 87 separate forms!  I daydreamed about a pen that after I scrawled an unitelligible swirl as a signature it would shoot a laser that burned the time and date into the paper as it set off smoke detectors in the administrators offices. To be even more passive/aggressive I wanted to date and time the orders in ancient Mayan but one of the other surgeons said their calender was over as the world ended!  Some guy in a suit said it would all be better once all the records were paperless as the date and time would be automatic.  Yeah, sure.  We are "paperless"!  Somehow, paperless means I have to sign more papers that the computer just spits out one after the other.

VA Spa

Like many surgeons, part of my training was done at the VA Medical Center or the VA Spa as it was known.  We called it the "SPA" because it was the place where you had to learn to  relax.  In our training at the University Hospital it was not uncommon to be working 17 hours a day.  You get  to the VA and they wouldn't even start any OR cases until 830 or 900.  If you happened to be operating after 230 you could look out the window of the door of your operating room and see that all the other lights were off and they had closed shop.  There was never a problem parking because even though the clinics were supposed to start at 8, most employees didn't show up to 830 or 900.  Everyone got 1 1/2 hours off for lunch not to mention every holiday. 

I say it was the place you had to learn to relax because yelling at the staff for not doing their jobs accomplished nothing.  In fact, they did even less.  There were those who really cared and tried, but the whole system seemed to be set up to punish those who tried to correct the problems.  I hope this recent publicity will finally bring attention to the whole problem.  Then again, the VA is government single payer healthcare!  Who knows the VA may be the model for the final Obamacare.

Sunday, April 13, 2014

Patient Grades

When I strolled into the surgeons lounge I saw one of our best surgeons sitting there with her head in her hands.  I sat down and asked if she needed to talk to someone.  Usually when I see a surgeon like that she just had to give someone bad news or no matter what she did he could save the patient and they were going to die.  Its a lonely place and sometimes it helps to be able to talk to a colleague to get it all out.

I wasn't prepared for what she had to say.  A few months before she had saved a patient from certain death, a bad mesenteric ischemia with perforated bowel.  The patient had a rough course but pulled through.  The patient was an IV drug abuser and the bowel infarction was a septic emboli.  Because the surgeon would not give the patient all the narcotics he wanted and instead set him up in a treatment program, the patient went on HealthGrades and slandered the surgeon up and down.  This is now the first thing you see when you google her name.  I did my best to console her but all I could think of is "We need a PatientGrades where we can list all the drug seekers, psychopaths and Munchhausen's patients!"

Sunday, April 6, 2014

Lordy Lordy, we just hit 40!

Just finished a week on call where I cover several emergency departments.  On average there will be about 60 consults for "emergencies".  In the past one third would be uninsured.  This week it was 2/3rds.  Worse 7 had insurance but had to drop it because it became too expensive. 

I guess I'm confused, I thought Obamacare was going to cover the uninsured and make it affordable.

Monday, March 17, 2014

McCarthy Orchitis

As of this morning there were 23 cases of mumps at Ohio State University with the epidemic expected to increase as the result of so many students that have not been vaccinated.  I wonder how many of them are also following Jenny McCarthy's other areas of advise and smoking E cigs?

Going Postal

I had to renew my passport and went to the Post Office where I thought I could get the picture and mail it right away as that is where I got the last one.  When I got there a sign was posted that said they had met their passport quota for the day and  were now closed.  I went to a  nearby shop that took the photo and I attached it to my application and went back to the post office to mail it.  When I got there, the passport window was now open!  I asked the person, "I thought that you had met your quota for the day?".  He said, "Oh, we put that up when we go to lunch".  I was about to ask "why don't you put a sign that says gone to lunch" but then the answer hit me.  People would line up and wait for them to come back.  By saying "quota met", people would just leave.  Gotta to love the Federal work ethic!