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Real Meaning At Christmas

slumsEvery day I go to work and spend time with suffering people. They come to me for help and for comfort. They open up to me with problems that they would not tell anyone else. They put trust in me — even if I am not able to fix their problems. I serve as a source of healing, but I also am a source of hope.

Christmas is a moving season for many of the same reasons. No, I am not talking about the giving of gifts or the time spent with family. I am not talking about traditions, church services, or singing carols. I am not even talking about what many see as thereal meaning of Christmas: Mary, Joseph, shepherds, wise men, and baby Jesus. The Christmas story most of us see in pictures or read about in story books is a far cry from the Biblical account. The story we see and hear is sanctified, clean, and safe.

Before I go on, I want to assure my readers that I am in no way trying to persuade them to become Christians. I am a Christian, but whether or not you believe the actual truth of the story, there is much to be learned from it. I find it terribly hard to see the real Christmas story here in a country where the season is filled with so much else — much of it very good. It is far easier to just be happy with family, friends, giving gifts, singing songs, and maybe even going to church, than it is to contemplate the Christmas story. I think the Christians in our culture have gotten way off base on this — much to our shame.

Christmas is not about prosperity and comfort. It is about help to the hopeless. Read more »

*This blog post was originally published at Musings of a Distractible Mind*

When A Doctor Is “Spent”

“I need you to do me a favor,” my nurse asked me at the end of our day on Friday.

“Sure,” I answered. “What do you want?”

“Please have a better week next week,” she said with a pained expression. “I don’t think I can handle another one like this week.”

It was a bad week. There was cancer, there was anxiety, there were family fights, there were very sick children. It’s not that it’s unusual to see tough things (I am a doctor), but the grouping of them had all of us trudging home drained of energy. Spent.

I think this is one of the toughest thing about being a doctor (and nurse, by my nurse’s question): The spending of emotional reserves. I’m not physically active at work, yet I come home tired. I don’t have to be busy to feel drained. It’s not the patients’ fault that I feel tired. They are coming to me to get the service I offer to them, and I think I do that job well. The real problem is in me. The real problem is that I care. Read more »

*This blog post was originally published at Musings of a Distractible Mind*

May We All Die So Well

Everyone liked him. Though his later years (the only ones in which I knew him) took away his ability to do most things, and though he was in great pain every day, it was easy to see the mischief in his eyes. The subtle humor was still there, coming out of a man who was weak, in pain, dying.

She lived for him. She was always telling me of his pain, frustrated with the fact that he didn’t tell me enough. She was anxious about each complaint of his, wondering if this was the one that would take him away from her. Many of her problems were driven by this anxiety and fears, and she spent many hours in my office giving witness to them through her tears.

As his health failed, I wondered about her future. He was the center of her life, the source of her energy, joy, purpose. How could she manage life without him? How could she, who had so much lived off of the care of this wonderful man, find meaning and purpose in a life without his calming presence?

Then he died. Read more »

*This blog post was originally published at Musings of a Distractible Mind*

Social Networks For Doctors: One Place At A Time

I suspect that in the next couple of years we’ll see the emergence of a viable social network for physicians. It hasn’t happened yet, but I suspect that we’re getting close. Physicians are increasingly dabbling in mainstream social sites.

But maybe that’s a problem. After all, a doctor can only hang in so many places. If you have “The Facebook for Doctors,” do you expect us to spend our time there instead of on Facebook itself? Maybe we will, and maybe we won’t.

Beyond the obvious requirement of a network to deliver value, I think the rate-limiting factor is old-fashioned bandwidth. You can only be one place at a time. If I spend my days on Twitter, I’m not likely to spend my days on said doctor’s network. I will go there for particular things and to talk to certain people about specific issues, but like most doctors I’m not sure I can tell you exactly what I want. I’ll know it when I see it. (Actually I do, but I’m keeping it tip-top secret.) Read more »

*This blog post was originally published at 33 Charts*

The Virtue Of Unnecessary Care

I case you didn’t hear the news, the American healthcare system is in financial crisis. One of the biggest culprits indicted in this crises is “unnecessary care,” with estimates ranging from $500 to $650 billion (total spending estimate is $2.6 trillion) going toward things labeled “unnecessary.” Personally I think this is an underestimate, as it doesn’t take into account the some big-ticket items:

  • Brand name drugs given when generics would do.
  • Antibiotics given for viral infections (and the additional cost due to reactions and resistance).
  • Unproven costly care considered “standard of care” (PSA testing, robotic surgery, coronary stents).
  • The unnecessarily high price of drugs.

One of the main reasons I am an advocate of EMR is to measure and analyze care, eliminating that which is wasteful, futile, or even harmful. The biggest burden on our system is not the fact that we have a hyper-complex payment system that hides the true cost of care. The biggest burden is the wasteful care that this system agrees to pay for. In fact, I suspect that the main reason our system has become hyper-complex and covert in its spending is to hide this waste from prying eyes.

It sounds easy: Just eliminate costly unnecessary care and save the system. While you are at it, why not bring world peace, eliminate poverty, and make a detergent that cleans, softens, and deodorizes all at once? Read more »

*This blog post was originally published at Musings of a Distractible Mind*

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