Friday, November 20, 2009
Benjamin Disraeli, First Earl of Beaconsfield and conservative 19th-century British Prime Minister once famously quipped that "There are three kinds of lies: lies, damned lies, and statistics. As I've become a student of public health statistics, I've found that Disraeli was right on target. Statistics in medicine is, more often than not, the science of deception using what should be the most unassailable of all techniques: mathematics. A skeptic of mathematics is, of course, immediately dismissed as an idiot or a nut or both. Nevertheless, I find myself in that dwindling group of physicians that views "studies", the new intellectual currency of medicine, through doubtful eyes.
This week's shocking reversal of opinion about the importance of screening for breast and cervical cancer by no less an authority than the American College of Obstetricians and Gynecologists (ACOG) indicates that I and my fellow heretics were right to be skeptical. This comes hard on the heels of the head-spinning announcement by the American Cancer Society that, on the basis of "studies", the benefits of routine screening for preventable cancers have likely been overstated, and that treatment of these cancers in the early stages may, in fact, do more harm than good.
Really? Three years ago, the American Cancer Society repudiated a British researcher's "evidence" that there was minimal benefit to screening for breast cancer in women under 50. This study, it should be noted, concluded that the undeniable benefits of early detection in women under 50 were outweighed by...cost (http://www.breastcancer.org/symptoms/testing/new_research/20061208.jsp).
It would not be insane to at least consider the political context in which these recent statements were made. If and when health care becomes a government industry, they have a strong financial interest in cutting costs. What is the real meaning of these recent announcements? They are the first evidence of health care rationing. When cost-containment is a primary concern, there are some patients who are cheaper if they will simply die before they get expensive.
The medical establishment has now completed its transition to government surrogate. Propagating their own brand of dubious evidence and pseudo-scientific "evidence", ACOG leaders can now attend the same lavish Washington cocktail parties attended by the other members of the enlightened collectivist intelligentsia and manmade-global-warming devotees. Real doctors - the men and women who actually treat patients every day - have been betrayed by the societies created to facilitate the effective treatment of disease. We can no longer trust our own societies. And sadly, patients feel they can no longer trust us.
Where do real doctors go from here? It's a pretty bleak picture. Real doctors are few. Having spent centuries mastering the science of medicine, we lost our way somewhere along the road and forgot what science was. Science is observation. Our real-life observations of our patients and their experiences, however, have been denigrated by the medical establishment for decades. "It's only anecdotal," they would say. "Where's your real evidence?" Generations of doctors have emerged from their training as automatons - depending on others to be their eyes and ears. We always assumed that those hired eyes and ears were working for the benefit of patients as we were. Instead, they were being paid to sign their name to ghost-written research. They were on the payroll of for-profit companies. They were on the payroll of a government who now shows its true motive - to become one giant cost-obsessed insurance company. Only now does my gut instinct about "evidence-based medicine" find things placed into focus. I pray it isn't too late for our profession and for our patients.
The first step is to do everything in our power to distance ourselves from the hopelessly corrupted medical establishment - and fast. They had already sold us out for transparent government promises; now our patients are their new targets. They must not be allowed to use our memberships as tacit approval of their actions. Cancel your memberships. They are worthless anyway.
We must, as real doctors with real patients with real concerns, secede from our "profession" and return to what we were entrusted to do. If the government and Big Insurance won't allow the market to work on the large-scale, we must endeavor to do it on the small-scale. I can do examinations for a low price for as many patients as will pay me a fair price for my services. If patients pay for their own mammograms, I'll bet we can find willing radiologists to read those tests for a discount - and end up better off in the end by-passing the endless paperwork and red tape. The increased demand for these procedures would, of course, lead to lower costs per procedure. I would be surprised if some enterprising pathologist wouldn't be willing to do the same regarding Pap smears. Nothing says that we can't do this on our own, if there are simply enough of us left. We don't need permission from the President, the HHS Secretary, or the insurance companies. We only need the approval of our patients. But most of all, we need their trust. If we start now, we can still salvage what is left of it and be real doctors again. If we start now, we may yet rescue our science from death by the strangulation of greed and corruption.
If we start now.
Saturday, October 24, 2009
President Obama has declared the outbreak of H1N1 influenza pandemic a "national emergency". This is a very serious claim. For those of us in health care, a mention of an influenza pandemic conjures up memories from countless stories in our training about the 1917-1918 outbreaks that infected an estimated 20 million people in the U.S. and likely killed 850,000.
The current H1N1 influenza outbreak, just to put things in perspective, has killed 100 Americans. There are, to be certain, 100 heartbreaking personal stories to accompany these tragic and untimely ends. We would do well never to forget this. There are real people with real families in real pain behind these nameless, faceless numbers.
But we have a responsibility to weigh this matter with tremendous care. We are being strongly "encouraged" at present to be vaccinated against this strain of influenza, and this latest "emergency" declaration suggests that vaccination may soon be mandatory. The vaccine has been rushed through production - there is no debate about that. There are reports that the vaccine itself may be dangerous. Are we better off taking our chances?
In this time of confusion and fear, we see in sharp focus why it is a problem when people in leadership positions lie. The President and his staff have rendered themselves unworthy of trust. From Rahm Emmanuel's oft-quoted mantra of "never let a crisis go to waste" to the constant din of misrepresentations and obfuscations concerning their health care take-over plans, Administration officials have built a bulwark of lies in their short time in office. Their HHS Secretary, Kathleen Sibelius, made her most powerful contribution to this effort by castigating a reporter who coughed incorrectly, without using his sleeve. The President himself calls physicians greed-obsessed tonsil vultures and serial amputators.
In this climate, when every statement from those in charge is suspect, this latest declaration lacks any convincing quality. Combined with the relatively low mortality numbers and the dubious quality and efficacy of the vaccine, I am left with no choice but to choose to take my chances. This is tragic. After all the advances made in the field of immunology, the work started by Richard Jenner and smallpox now finds its hard-won trustworthiness undone - not by failure, but by the careless abuse of power by a self-obsessed and single-minded fascist.
Once again, the danger of health care dominated by an all-powerful State is clear. There is no longer any objective science. All the researchers are controlled by them. The CDC belongs to them. The media belong to them. Resistance is futile. Maybe the conspiracy theorists are right and the vaccine is some sort of mind-control ploy. Or perhaps they are simply flexing their political muscle. Maybe they are simply using an engineered crisis to overwhelm the system to bring about their further take-over of all facets of American life. More likely they are simply using the crisis to line their pockets in some way.
Or maybe this really is a big deal, and the blood of millions will be on their hands. No shots will have been fired to achieve this genocide. All it will have taken will have been a few lies.
Thursday, October 8, 2009
This shocking lack of consideration for the rights of their constituents is made even more noxious due to the fact that they are now on the record refusing to promise to read it themselves.
So we are expected to sit back and allow them to commit our tax money for a program with the potential to balloon out of control (as has every socialized health care scheme on earth) with no one minding to spend the time to actually see what is in the bill.
My guess is that they accurately believe that we would be outraged by the stunning lack of honor demonstrated by the text, like...oh, I don't know...Harry Reid's little ploy to save his Senate seat by making Nevada (and only Nevada) exempt from having to participate in the state contribution portion of Medicaid. That means that all the medically-indigent patients in Nevada will be paid for entirely by money from taxpayers from the other 49 states, who also get to pay taxes for their own medically-indigent population, as well as contribute to the state contribution to the program.
This is despicable, but not really surprising. Harry Reid is a sleazy scumbag. None of us needed this to convince us.
The bottom line is this: we must demand, loudly, to be able to read the bill. The stakes are just too high for this catastrophe to occur without anyone knowing what is going on.
Thursday, August 27, 2009
Some are superb hunters and kill more than they need – the excess is traded to others, to the benefit of both. Some make the best bows, and make many more than they can use. They “sell” the excess for something that they need – perhaps to the hunter in exchange for meat. This arrangement is through mutual consent and results in their mutual benefit. If the hunter decided to keep all that he killed, it would be left to inferior hunters to hunt their own meat, to their mutual detriment.
To suggest that the natural state of man is socialistic or fascistic in the modern sense is laughable. Primitive man would see no function to be served by the bureaucrat – who neither hunts nor sews, nor does anything else productive, for that matter – whose only function is to redistribute in a more “equitable” way, being sure to skim a little for himself in the process.
No, the function of the bureaucrat is more closely approximated by another historical figure – that of the biblical “tax collector”. These detested men were the agent of a foreign and deaf government, and made their living by extorting money from the taxed.
Now is the age of the bureaucrat. These modern-age “tax collectors” have so imprisoned us, so choked the very natural act of free trade between free peoples, that they have secured for themselves a permanent place in our society, constantly draining its life-blood – never quite enough to kill their host; just enough to make it anemic and sick.
They have twisted our thinking. We have believed their lie that without them, we would be lost. They have so consistently and successfully led us astray, and for so long, that we now almost believe them when they say that we are inherently evil and unjust to our fellow man; that without them, our free trade between free agents would result in unmitigated suffering; that without their leadership, we would all fall off a cliff of our own greed to our demise.
If that were true, if mankind so desperately needed a bureaucrat for its survival, then surely our weak and pitiful species would long ago have been rejected by an unforgiving planet.
I ask again: what could be more natural than working for one’s own living? And if this is true, what could be more evil, more destructive to that natural state of Man than the demented twisting of that natural productivity into the instrument of Man’s torment?
Under the thumb of the bureaucrat class, millstones are tied to the necks of the most extraordinarily productive, thus negating the potential benefits their natural gifts might otherwise give to a grateful society. On the watch of the bureaucrats, the least productive are elevated to positions of supremacy and lordship. When the natural order of things is so drastically changed, one has to wonder what is at work. Certainly this chaos is not a natural phenomenon. Rather it is being done to us intentionally. And to find the source of our discontent, one needs look no further than the ever-more-powerful tax collector/bureaucrat.
And while there is redemption, even for the tax collector, he must recognize that his work, stealing behind a cloak of legality, is evil at its core. His theft from the productive to sell favors to the unproductive is no righting of wrongs – it is the unleashing of a poison that eats at the heart of society itself.
I’ve heard a particular phrase so often that it no longer has the sting of a lie – it has the soft sound of the accepted truth: “One must serve society…” This is an infernal misrepresentation. Man was never meant to serve society. Society was created to serve him. Society should not be a burden. If it were, primitive men long ago would have abandoned it in favor of the natural liberty God gave them.
Society is a tacit contract between equals – undertaken to the mutual benefit of all. When one man uses that society as a weapon to disenfranchise another, whether that other is poor or rich, it is not social justice. Neither is it justice when people are taught to genuflect before a superior for the means of their very existence. No, these are not symbols of social justice. Instead they represent the most despicable form of social injustice. They are the hallmarks of slavery.
Tuesday, August 25, 2009
There are approximately 63,000 American troops in
More troops have died in
Somehow, this has escaped the notice of the “Support the Troops, Oppose the War” crowd. They accused G.W. Bush of “genocide” during his terms, and protested with bloody hands and faces contorted in pretend-grief. Yet their vitriol has fallen strangely silent now. I’m certainly no apologist for G. W., but this doesn’t pass the smell test with me. “Hypocrites” doesn’t seem to quite capture it.
No, as usual it will fall to us to support, care for, pray for, and uplift the Soldier, the Sailor, the Airman, the Marine, to an all-sufficient God, trusting that He is able to protect those we love from danger.
Once again, we fight in silence. Without fanfare. Without help from well-funded political machines, nor desiring such help. The veterans. The wives and husbands. The mothers and fathers. The children. The America-lovers. The Liberty-protectors. The productive, the independent and self-sufficient.
Those of us who struggle in silence, neither seeking hand-outs nor demanding apologies; working to feed our families, and, it turns out, many others’ families as well. Once again, we will take time out before, after, or during our seemingly interminable toil to offer thanks for the opportunity to work an honest day, to beg mercy for ourselves and our families, to ask forgiveness for our shortcomings, and to offer a heartfelt prayer for men and women, many of whom we have never met and will never meet.
We will ship care packages as our mothers and fathers taught us to do, and as they learned from their mothers and fathers. We will send letters. We will pray prayers. This is our work as those who love what our country used to be and what, God willing, it will be again someday, when this madness is past.
We may shed a tear as we realize how blessed we are to spend our nights at home with our loved ones, and as we realize that there are 63,000 American heroes who have chosen to spend their nights away from theirs as their gift to a nation that can not, will not understand the nature of that sacrifice.
Finally, with tears rolling down our cheeks, the returning heroes, embraced by loving arms or by the flag they faithfully served, will be welcomed home. Without fanfare. Without vitriol. Without expectation.
And then, still silently, we will return to work as before.
At long last, the odd and twisting case of the death of pop icon and tragic precautionary tale Michael Jackson has been solved. It was, it turns out, murder. His killer? The American private health care system.
So says immensely-qualified sage Charles Osgood, known best by his dulcet-toned CBS Sunday Morning hosting duties, but also, apparently, an expert on the complexities of health care.
“Michael Jackson was one of those Americans who liked his health care plan – and decided to keep it,” chides Charles Osgood. “That health care plan was Dr. Conrad Murray and his supply of sedatives”.
Yes, Mr. Osgood. That is definitely an apt analogy. The majority of the American people are just like Michael Jackson. We all have private doctors, hired at $100,000 per month, who are under orders to give us rhino-doses of tranquilizers. At this point, the 24-hour senility watch on Mr. Osgood should have sprung into action. But sadly, he rambles on:
“And yet, he [Dr. Conrad Murray] was only doing what his patient demanded – and in a way, what you hear many Americans demanding: providing privately-funded health care, unfettered by government regulation of any kind…”
Well said, Charley. Oh, and as a doctor myself, I really appreciate your point-of-view. Let me see if I’ve pretty much got your point, okay?
1. Americans who like their health care plan are just like Michael Jackson.
2. The illegal abuse of a corrupted physician’s privileges by a sad, twisted personality with the money to buy and sell some people like furniture, and the selling of wildly improper and dangerous care, just to make a buck, is a perfect analogy to the way most Americans interact with the health care system.
3. By extension, people who are drug addicts are simply exercising their right to health care choice, too. They’re not “drug dealers”; they are “curbside pharmacists”.
4. By further extension, men who visit prostitutes are simply exercising their rights to health care choice as well. They’re not hookers; they are “reproductive therapists”.
5. Doctor Murray was a very typical doctor. His willingness to inject massive doses of surgical anesthetics into an emaciated and clearly-addicted media personality is exactly what the hundreds of thousands of health professionals are forced to do on a daily basis. We are mindless drones, our finely-honed skills for sale on the open market, to be used, misused, or abused at the behest of the highest bidder. We are stupid, idiotic, and depraved vessels of medical knowledge, ready to bow to any master, whether government, insurance industry, or rich patient. Thanks, Charley. I guess lousy journalism is the only respectable profession left.
6. Americans demanding that their government stay out of their private decisions about how they hire people to care for the health of them and their children is rash, erratic, and irresponsible. They are idiots, incapable of even self-preservation without “government regulation”.
I won’t presume to speak for the entire physician community, Mr. Osgood. As for me, though, I would find your genuflection at the altar of medical fascism to be deeply offensive, were you not so entirely irrelevant. You are as important to the real nature of this debate as your contemporary Andy Rooney, but without the Vaudeville side-show entertainment value.
I am glad to hear that you think that people who gripe about changes in their health care are so repulsive, though. I’ll be sure to remember that when Medicare goes down the tubes. Will you remember to keep your mouth shut? Or simply fulfill your destiny as a journalistic hypocrite?
The hypocrisy is almost unbelievable. On MSNBC’s The Rachel Maddow Show, Dean claimed that Republicans are so obsessed with undermining President Obama that they are willing to “undermine the country” in order to do it. He laments the fact that Republicans and Democrats can no longer sit down and work through things.
Why on earth would anyone try and sit down and discuss anything with fascist-leaning Democrats? What possible benefit could come from negotiating with them? There is not a single thing about fascism that I want to give in to. They have nothing to offer that is beneficial. I do not want the government to control industry. I do not want government to control health care. I do not want government to control finance. There really isn’t anything to “sit down and have a conversation” about, Governor Dean.
As for undermining President Obama, well, yeah. I guess I do hope that he is undermined. Since he has conclusively demonstrated that he is an enemy of the U.S. Constitution, he is to be resisted and defended-against. So are all the other Democrats.
They are attacking the Constitution. They are making us unsafe in a world that wants to destroy us and our freedom. They are spending us into an oblivion that will make us weak, poor, and indentured for generations.
As for undermining the country – Obama and his American fascist party are doing that without a single finger being lifted to help.
Monday, August 24, 2009
I felt a strange wistful feeling of melancholy earlier this month when I learned that a new urine test was capable of diagnosing these diseases. The old way that I'd always used - a good old sterile cotton swab - seemed okay to me.
Of course, the "old" method was still better than the Inquisition-worthy method described to us as raw Marine recruits in the early 90s. I won't go into any gory detail, but I'm sure you can imagine what sort of twisted sadistic lies can be cooked up by drill instructors intent on helping young Marines to...err..."...keep [their] honor clean...".
I felt many things when hearing these men explain the non-existent procedure used by the Navy doctors to diagnose "the clap". Not once did I feel "manly".
But I'd rather light a candle than curse the obvious darkness. Hey, the glass is half-full, right?
To my brother Marines; to all the soldiers, sailors and airmen fighting these clowns: this is simply a rare second chance to do things the "right" way this time.
After his brief homecoming in Kabul, this dude will be back on the lines. I wouldn't dare presume to tell you what you should do, but I will say that I, for one, won't be shedding any tears if this terrorist's next encounter with you ends a bit differently.
Since we're all buddy-buddy now, all open with each other about our feelings, Mr. President, I think it will be okay if I tell you now that I was offended when:
2. You accused family doctors like me of amputating the feet of diabetics because it pays better than doing the right thing.
3. Your party called me a "Nazi".
4. Your party called me a "brownshirt".
5. Your party called me an "insurance industry plant".
6. Your party called me a memeber of an "unruly mob".
7. You set up a website for "fishy...misinformation" (translation: the truth) about your plans for health care for no other reason than to intimidate me into silence.
8. You claimed I could keep my insurance even though you know that is a lie.
9. You claimed my patients could keep using me as their doctor, even though you know that is a lie.
10. You resumed the hideous practice of encouraging disabled and sick military veterans to contact the Hemlock Society for advice on what to do rather than get appropriate treatment.
11. You framed your support for socialism as some sort of Christian "moral imperative" to a staged audience of religious leaders of the most liberal possible stripe.
12. You apologized to our enemies and our allies for how lousy you think our country is. Again, and again, and again, and again.
13. Your Homeland Security Department described people who disagree with expanding government as "Right Wing Extremists" (a.k.a. "terrorists").
14. You told Planned Parenthood that you supported taxpayer-funded abortions, then lied to our face and said that you don't.
Shall I go on? No...I don't think so. I'm glad we had this little chat together. I feel better. Hope you do too. And I am really sorry that you are offended at the truth. That must be really difficult for you. I wish I could say that I won't do it again, but you see, those of us in the real world have to deal in truth. We don't have the luxury of lying and bending the truth for political expediency. Real men tell the truth, even when it hurts.
I pray every day for your wisdom and good judgment as our President. Furthermore, because I am commanded to, I forgive you for your repeated offenses against me and the people like me.
Please start telling the truth. It might be liberating.