We are a commune of inquiring, skeptical, politically centrist, capitalist, anglophile, traditionalist New England Yankee humans, humanoids, and animals with many interests beyond and above politics. Each of us has had a high-school education (or GED), but all had ADD so didn't pay attention very well, especially the dogs. Each one of us does "try my best to be just like I am," and none of us enjoys working for others, including for Maggie, from whom we receive neither a nickel nor a dime. Freedom from nags, cranks, government, do-gooders, control-freaks and idiots is all that we ask for.
Our Recent Essays Behind the Front Page
Monday, January 6. 2014
We don't call it "dying of old age" anymore because we have much better diagnostic tools. Everybody has to die from something or other.
Sunday, January 5. 2014
It's a vivid description of what we used to call Anxiety Neurosis but now term Generalized Anxiety Disorder. Stossel says that nothing has helped him except for moderate use of Xanax and/or alcohol. He has concluded that he just needs to live with it, if not to embrace it.
Thursday, January 2. 2014
81% of kids have a mental disorder? "Everybody has Psychiatric symptoms."
The point is, you need a diagnosis for your insurance. Even if you're a troubled normal neurotic, we'll stick a label on you as a favor to you. Dr. Alan Francis, et al (h/t, Boring Old Man)
Tuesday, December 31. 2013
It is true. Docs who use electronic records spend more time on the computer than with their patients. Even worse, the treatments are increasingly done by prescribed protocols instead of designed for the individual situation. Case in point: When treating a patient with dementia, electronic health records fall short.
Furthermore, those records are not private. This is what you get when government gets more involved with medical care - and anything else.
My patients know that they are not on an assembly line, and I'll keep it that way until they make it illegal. Doing things my way, however, requires that I take no government insurances. Just pay me for my time at around the same fee as a master electrician and below the rate of a fancy lawyer.
Friday, December 27. 2013
The difficult thing about CPR is knowing who needs it. I have heard stories of people doing CPR on people who were choking, and on people who simply fainted.
Saturday, December 21. 2013
Asperger's Syndrome has been removed from the DSM and folded into Autism Spectrum. I'm not convinced that people with Asperger's-like symptoms have anything in common with what was traditionally termed Autism, and my suspicion is that Asperger's is just a normal human variation which, a while ago, might have been termed "slightly eccentric."
The comments here are interesting: Convergence in the meaning of "autism"
Thursday, December 19. 2013
Monday, December 16. 2013
Sunday, December 15. 2013
The government thinks they know how to practice medicine better than we docs in the trenches do. They have no clue.
I'll admit that some of what doctors do, many expensive things, are purely defensive medicine. Lawsuits are inconvenient and no fun, but we all get sued. Most of the time, we either win or our insurers pay them to go away, but it's a major interference with our work and our mental bandwidth.
Each and every medical decision can be questioned, because it's all an individualized art requiring individualized judgements.
Physicians take a solemn oath to do what they believe is best for their patient. It's always a complex dance, of course, with the doctor recommending and the patient thinking about what they want.
We accommodate patients' desires all the time, even when we believe that they are wrong. It's a free country, is it not? We work for, and with, the patient. Nobody else.
I am 100% out of government medical care.
Friday, December 13. 2013
Fortunately, we have ways to quiet these demons nowadays. Hormone replacement, antidepressants, or both.
Wednesday, December 11. 2013
What qualities do people look for in elected (or unelected) leaders? The question applies to all areas of life, not just politics.
What qualities stimulate people to "follow," or choose, a leader? Among others, physical presence, ability to speak, self-confidence, and reliable decision-making play important parts, but some of it is difficult to express. This post stimulates the discussion: What is the "Presidential Presence"?
One component of it, perhaps not a large one, is a person's aptitude for being a target of positive transferences. That, plus the power, is what transforms an employee of the citizens (ie a politician) into something that seems special, probably too special. After Washington, my favorite President was Coolidge.
When it comes to politics in the modern era, one part of it is simply celebrity. "Charisma." TV, video, and film create celebrity, as in "famous for being famous." What qualities support that? Why does anybody listen to, or pay attention to, celebs?
Friday, December 6. 2013
It's just a matter of degree. Shouldn't the government simply put Prozac and amphetamines into the water supplies? Historically, one of the selling points of Coke was the coke in the mix.
Posted by Dr. Joy Bliss in The Culture, "Culture," Pop Culture and Recreation at 13:54 | Comments (6) | Trackbacks (0)
Tuesday, December 3. 2013
The latest very large study says it's not really possible: Fat and healthy is a myth, new study says.
Medical risks associated with being overweight include breast cancer and several other cancers, cardiovascular disease, arthritis (esp. knee), diabetes (obviously) along with other insulin-resistance-related metabolic syndromes and carbohydrate-craving, non-alcoholic liver disease, pancreatitis, stroke, hypertension, gall bladder disease, sleep apnea, and many more fun problems.
Tuesday, November 26. 2013
Monday, November 25. 2013
In a short piece discussing shyness vs. Social Anxiety Disorder, Dr. Kristy Dalrymple has this to say (my bolds):
That's what I've been saying for years, but she says it better.
Sunday, November 24. 2013
I am not sure what science has to do with ethics, or what they mean by science. Everything is called "science" now - political science, social science, etc.
Also interesting: Male And Female Brains Have Different Gene Expression
Posted by Dr. Joy Bliss in The Culture, "Culture," Pop Culture and Recreation at 10:42 | Comments (2) | Trackbacks (0)
Thursday, November 21. 2013
Well, for starters there is no such thing; just people with varying degrees of self-respect, dignity, and self-control. Humans are apes, after all.
Via Instapundit, an Antioch student who does whoredom on the side
A sex object, and proud of it
It's not exactly news.
In my view, of course not. Science cannot even answer science questions but can only offer up their best theories du jour. Just ask Feynman. That's what he always said. Science is a method of pursuit, rarely gives us permanent facts.
About Sam Harris’ Claim That Science Can Answer Moral Questions
Wednesday, November 20. 2013
It depends. As Freud knew, memory is distorted by our choice of defensive narrative of the moment. One of the many fascinating things about Psychoanalysis is to see how memories change over time.
In Psychiatry, rightly or wrongly, we are able to work in the world of psychic reality rather than courtroom facts 99.9% of the time.
Sunday, November 17. 2013
It has become a big business: Addiction Treatment With a Dark Side - In Demand in Clinics and on the Street, ‘Bupe’ Can Be a Savior or a Menace
It's an opiate agonist/antagonist. Apparently it's a mild high. I know a doc who prescribes it. He is all about $.
Saturday, November 16. 2013
The article spins the imaging data to be about crime. It's not about crime, it's just about the young male brain as compared to the female. It's not a bug, it's a feature. Young male humans are designed to defend the tribe, to kill food, and to be willing to die doing those things, but no brain scan can explain that. Vive la difference.
Thursday, November 14. 2013
I recall my first deaths in medical school, in the ER. Two ambulances, family of four after a parking lot accident. The cool efficiency of the ER senior resident doing five-second triage: the 7 year -old - "Dead." The ten year-old - "Dead." The Mom - "Dead." The dad, blue but not grey like the others - "Breathing. Get him in a room and let's work on him. Tube here now, chest tube, EKG, crash cart, IV. Get a surgeon down here. Let's go, team."
In just a couple of minutes the unconscious Dad was intubated, had an emergency chest tube, IV, monitor, etc., survived.
Friday, November 8. 2013
It's become clear to me that people are divided into two basic camps on medical insurance: those who want to insure cheaply against major expense and those who want what amounts to pre-paid medical care. In any event, it is stunning to me that 85% of Americans were content with their medical care situation pre-Obamacare so I'm not sure that represented any crisis requiring massive Federal intervention and control.
As someone whose bias is against government getting involved further in our lives, if I were King here's what I would do about medical insurance - free it up:
1. I'd permit medical insurors to create national markets for insurance, like MLS does with real estate. They would be happy to do so were they free to do that.
2. I'd make medical insurance portable across state lines, and detach it from employment. If any employer wants to chip in, or if a union contract requires a business to chip in, fine. They could offer vouchers as a benefit, if they want to.
3. I'd demand that insurors insure everybody who wants to buy some, creating high-risk pools just as they do for auto insurance if needed.
4. I would permit the freedom to sell any kind or style of medical insurance people might want with whatever sort of coverage they want to buy. Or not to buy, if they want. It's a free country, and people are free to be foolish or to trust in the benevolence of others.
5. Regarding Medicare and Medicaid, I would fold them together somehow as means-tested charities for the poor, run by states or municipalities.
(As an off-topic aside, let me tell you the problems with many government-paid Medicaid patients and charity patients: they miss appointments, they are not appreciative and treat you like a servant, they will not make morning appointments, they resist advice, their fees do not pay the rent so docs have to limit their numbers - and they are prone to lawsuits against you. I know about this, because I do around 10-15% charity work in my office as my form of tithing, volunteer one day/week in a charity clinic, and teach for free 1/2 day/week. Just another greedy doc. )
Addendum: A reader asks about tort reform. Good question. God knows how much of medical expenses are CYA by docs and hospitals. The reality is that medical care is an art, and that any medical decision can be challenged or questioned if somebody wants to sue their doc.
What would you do if you ran the world?
Monday, November 4. 2013
Good grief. I suppose that will ensure steady work for the public health people forever.
In a related piece, The Radical Case for Bloomberg's 'Nanny' State