Category Archives: Humor
Toddler down to 15 cigarettes per day.
That links to a video of a rather chunky three-year-old (by my guess) puffing like a veteran. As docs, we regularly take a smoking history from our patients. Do you use tobacco? Smoke, chew . . . which? How much? When did you start?
This all translates into a metric, the “pack-years” logged by the patient. The earlier you start and the more you smoke, the higher your pack-years. All of us remember our record-holder. Mine was 120. How does a sixty-something guy log 120 pack-years? By starting at age five and averaging two to three packs per day.
How does this happen? Uncles, grandparents, sometimes even parents give the kid a cigarette — you know, because it’s cute. And we’re talking about nicotine, one of the most (if not THE most) addictive substance known to humankind, more addictive than heroin or cocaine. Doesn’t make much work to turn the kid into a coffin nail junkie.
These kids, they’d probably be doing themselves less damage swigging 40-ounce bottles of malt liquor. And they’d look much cuter doing it, too.
The things we do to our kids . . .
D.
I got my patient in ASAP. You’d want to get in ASAP too if you had something crawling in your ear. I expected to find the usual cockroach, and indeed, my patient did not disappoint. But it was more than a cockroach.
It was Cockroach Plus.
Uh oh theca.
Cockroach plus ootheca, to be exact — an egg case. This was a female caught embarazada. Knocked up. Up the duff. On stork watch. Wearing the apron high. In the pudding club. Eating for 48.
And she was desperately trying to fulfill her Darwinian destiny in her last moments on Earth.
By the way, the egg case pictured above belongs to a Madagascar hissing cockroach, a beastie we used to breed in days of yore. And if you had one of them in your ears, you’d really have something to worry about.
Don’t know why Cockroach Plus should be so much more disturbing than Just Plain Roach, but it was. But hey, I’m a professional. I squirted some lidocaine down the ear canal (paralyzing and more or less killing the critter) and removed it piecemeal with suction and alligator forceps. End result, one happy patient who took the roach-bits home wrapped in gauze. So who knows, perhaps that egg case will find a happy home after all.
I told Karen all about it. She wanted to know, why didn’t it just back out?
“They can’t back out. Didn’t you know that? Don’t you remember the earwig episode on Night Gallery? They have to eat their way through to the other side.”
“Oh. Night Gallery. That’s your authority on this, huh?”
Yup, that’s my story, and I’m sticking to it. If it weren’t for me, the she-roach would have eaten it’s way through, laying eggs en route to the other side. Hey! I just remembered, there is a phrase for this in Hebrew — pikuach nefesh.
To save a life.
D.
Believe it or not, in med school we did receive instruction in medical ethics. Our teacher was a minister, if I remember correctly, but he usually did not have much of a judaeochristian bias — at least, none that I could detect at the time. One day, he talked to us about euthanasia, and while sympathetic to the cause of euthanasia’s proponents, he felt certain that doctors had no business practicing euthanasia. “We need another professional specialty altogether,” he said. “Call them thanatologists.”
The two things I remember from that moment: the uncannily bright grin of one of my classmates, a fellow we’d nicknamed Mickie Mouse for his uncannily bright grins, and who would eventually go into psychiatry; it was as if the clouds had parted and he had looked upon the face of God. Like he had found his home. Sometimes I wonder what he’s up to*.
The other thing I recall: a loud and persistent thought. Why isn’t this our domain? It’s all a matter of how you view doctors. If our role is to keep people alive, then yes, euthanasia is a clear conflict of interest. But if our role is to relieve pain and suffering, then euthanasia should be part of the job.
About this time, the late 1980s, Jack Kevorkian was just getting started in his role as “death counselor,” soon to be death facilitator, eventually to be known to the media as Dr. Death. The media loved to portray the man as a ghoul. Sometimes I suspect that he reveled in this caricature; his artwork, which could best be described as “fitting for the Night Gallery,” would do nothing to destroy this image.
Knowing Time Magazine, I wouldn't be surprised if they had picked murderer.
While Kevorkian initially acted as a facilitator, he ceaselessly pushed the envelope. As long as he served as facilitator and not prime actor, he was judicially unscathed, thanks to the craft of lawyer Geoffrey Fieger and the sympathies of the juries. (When people are forced to confront the prospect of their own deaths, few would not want the option of a painless passing.) But when he himself administered the euthanasia drug to an ALS patient and then arranged for the videotape to be broadcast on 60 Minutes, the D.A. went after him. Kevorkian unfortunately represented himself in this case, and was ultimately convicted of second degree murder. He was ultimately paroled in 2007 after a little over 8 years in prison.
You Don’t Know Jack (HBO) is a wonderful bit of docudrama, not to be missed. Susan Sarandon stars as Hemlock Society member Janet Good, John Goodman as Kevorkian’s friend and assistant Neal Nicol, and Al Pacino plays Kevorkian himself. And while I like Pacino in just about anything he does, I have to admit that lately, Pacino plays Pacino and it’s rare to see him play anyone else. But in You Don’t Know Jack, Pacino lives and breathes Kevorkian. If you’ve ever watched Kevorkian on TV (and if you haven’t, I’d be surprised if he isn’t well represented on YouTube), you’ll find the resemblance striking. Also remarkable casting: Danny Huston as lawyer Geoffrey Fieger. I had to google “Geoffrey Fieger” to make sure he wasn’t playing himself.
I can’t praise this one enough, people. It’s a thoughtful, albeit biased analysis of the issue of doctor-assisted suicide. If you’re looking for a character in this film who can provide a cogent argument against euthanasia, keep looking**. Much like its subject, the movie has an agenda. But it was entertaining, too — funny, poignant, and above all a showcase of terrific acting.
D.
*Ach, what a disappointment. Just googled the man. He’s a successful molecular biologist at U of Chicago . . . not a thanatologist.
**Really, the only argument that comes close to being persuasive is the possibility for abuse by next of kin; but abuse to the point of death can occur in many and varied ways, from neglect to outright physical harm, and the law is there, ready to punish the offender. Euthanasia, since it is such a public act — it must ultimately pass muster with a coroner, I would think — could be easily regulated to greatly reduce the possibility of such misuse.
Yesterday during the day, that was only the tip of the iceberg. Last night and today were the whole damn glacier.
Right now I’m in this weird mode (which I remember well from residency) of expecting the pager to go off at any moment. Or, worse, anticipating that it will go off only after I fall asleep.
What makes it all worthwhile: stopping in this evening to see my patient, an old fellow who had rather abruptly turned the corner. I’m not sure which of the two of us was more relieved. He, I suppose, but his nonchalance makes me wonder if I were the more emotional one.
He could still go south on us but I doubt it. My other patient, the one who gave me fits yesterday — that’s who’s gonna cause me trouble tonight.
I need sleep.
D.
He lost Karen and me months ago, soon after we realized he was caving on his campaign promises and selling America out to the banks, Wall Street, etc. But for a very long time, a very vocal majority shrinking majority minority on Daily Kos continued to beat the drum for Dear Leader. Trust Obama! He’s smart, just because you don’t understand his maneuvering doesn’t mean he lacks a brilliant plan! At times, it’s been hostile for Obama’s critics. You know, those of us who wanted to see the previous administration’s criminals brought to justice, the black sites scotched, the Iraq War brought to a close, true health care reform brought to fruition, an aggressive gay rights agenda (drop Don’t Ask, Don’t Tell for starters) etc., etc. . . .
But now he’s lost the left — over health care reform. In case you’re apolitical, the health care reform package now needs to be called the health care “reform” package, i.e., it’s been neutered to the point where it is now a blessing to the insurance industry and a curse upon the rest of us. (Well. Except for me. I suspect the current bill would be very good for my employers*.) Howard Dean called them on it, spoke the truth about a crappy bill, and now the President and all of those Democrats who were eager to sign a bill and declare victory (no matter what was in the bill) are savaging Dean.
If the Daily Kos crowd loves anyone more than Obama, it’s Howard Dean. Big time. You don’t go after Dean and retain the Progressives’ love.
Proof: in a matchup against the fictitious amphibian Hypnotoad, the President currently takes only 13% of the votes. He’s losing Keith Olbermann, too: Olbermann brought up the prospect of Obama getting primaried in 2012.
Let’s hope the Teabaggers aren’t the most organized political movement in ’12. President Palin, anyone?
D.
*And if I make partner, I WILL BE PART OF THE EVIL CABAL!
Over at Daily Kos, they’re having a name-a-thon for the C-Street house which serves as base-of-operations for the uber creepy Christian cult, The Family, host of John Ensign, Mark Sanford, and heaven only knows how many other Republican miscreants. My favorite new name for The Family’s C-Street abode: The Elephants’ Boneyard (kudos to DKos user ceratotherium). There are other good ones, but I won’t spoil the fun of the search for you.
It’s satisfying to watch The Family wallow in all of this bad press. Ever since I read Jeff Sharlet’s essay for Harper’s, “Jesus Plus Nothing” (accessible online), I’ve worried about these flakes.
Elephants’ Boneyard . . . snicker.
D.
I’ve done the big anniversary blogs in years past. Not much more to add. We’ve been too busy preparing for the big move to do much celebrating . . . so we’re delaying gratification, something us folks in the medical field know about only too well.
So how about Mark Sanford’s latest interview, eh? Saying that he had never felt the same way about any other woman than he did about his Argentinian squeeze. Saying that she was his soul mate. Wow. And this is a guy who is trying to get back together with his wife?
Karen has a theory that makes a hell of a lot of sense.
This man hates his wife.
Cheers, y’all!
D.
From grammar, we proceed to spelling:
D.
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