Balls and Walnuts
more than you ever wanted to know
Not bitter
Back in Crescent City, every few months a patient would check out my diplomas and say, “What are YOU doing HERE?”
The implication was that someone with my background shouldn’t be practicing in a small town. He should be some big name somewhere. And that’s the nicest interpretation of “What are YOU doing HERE?” More than once, after I explained my reasons, the patient would add apologetically, “Well, you know how it is. We tend to get a lot of other people’s fuck-ups.” Or language to that effect.
***
Tonight, I had dinner with an old friend and classmate. We compared notes, and we decided that life isn’t fair. Life doesn’t reward you for how well you did as an undergrad, nor for the fact you passed your boards the first time through, nor for providing quality care to your patients. Who does life reward? A whole lot of shmucks.
There is no fundamental relationship between brains and success. (Okay, I just added “pointless whining” as a category for this post. I’m not taking myself all that seriously.)
I talked to Karen about this tonight. “Is it luck? Is that it?” I wanted to know. Or do my friend and I lack some je ne sais quoi?
Karen thinks it’s the latter, and she has a name for the nameless je ne sais quoi. Salesmanship. My buddy and I both thought we could become successful practicing ethical, quality medicine. Boy were we ever wrong. We forgot about salesmanship!
We’re looking forward to the day when Universal Healthcare hits. Then we can just be docs, and be content in the knowledge that that jackass down the street/upstate/across country who we know doesn’t give a damn about his patients but still makes a million a year? That jackass will be making the same salary we are.
There’s a problem with that fantasy, though. There always is. Two problems, in fact.
(A) That jackass will still be raking in the dough by doing botox and restylane injections.
(B) A doctor dies and goes to heaven. (Hey — it could happen!) He says to God, “Lord, I have one question. Will America ever have Universal Healthcare?” And God says, “Yes. Yes, it will.” Dramatic pause if you tell this joke out loud. “But not in my lifetime.” Ba dum dum.
D.
Too many people equate Universal Health Care with socialism. It’s wrong, but there it is.
Yeah, what’s up with that? I hate that. And I’m a socialist.
My only problem with UH is that it depends upon someone with intelligence setting it up in the first place. After 8 years of W, my confidence in govt is at an all time low.
It’s also a how-you-frame-it-job. Gotta redefine success so you’re in there.
After all, those big time researchers don’t have a life outside of work.
The more money you got, the more you end up depending on things that aren’t actually necessary to peace/happiness/love blah blah blah so the further you are taken from that which is real and true.
As you can seeeeee, I’ve had practice at this redefining success bullshit.
not that you’ve so much as mentioned about the big bailouts for Fred Fan and AIG but here’s my favorite headline on that one:
“Foxes Demand Chickens Pay For Cleaning Up Blood in Chicken Coop” over at dkos
It’s a moving target, this ‘success’. No matter where or who you are, there is someone with more, and ‘success’ always seems to mean ‘when I have as much as that guy’.
I have no idea whether or not I’m ‘successful’, but I know that a lot of the time I don’t feel that I am. Happens when I compare my house to other people’s houses if their houses are nicer than mine. Happens when I compare my car to other people’s cars if their cars are nicer than mine. It’s a weird sort of thing: I don’t compare cars or houses if theirs aren’t noticeably nicer, only if they are.
Success is always out of reach, in other words, and still I worry about it.
Oh… you’re definitely right, though. I’m a smart guy, very good at my job, concientious, hard-working, get along well with others… and yet I haven’t progressed up the ladder at all, while I’ve watched people with less skill get on because they are better at the office politics game.
Because physicians are mere humans (although some may think they are gods), they possess the same character flaws as the rest of us mortals: ignorance, greed, hubris, and so on. American women routinely were advised to undergo unneccessary c-sections and hysterectomies because ob-gyns have mortgages too. And that whole HRT thing – a guaranteed income stream for the life the patient for both the prescribing physician and the drug maker – no matter that the patients lives got shortened in the process. My ob-gyn ridiculed me when I refused HRT. We need more physicians like you.
Thanks, lucie.
Now that i’ve had time to sleep on it, I don’t think it’s the money that burns me. No, it’s the feeling that I’ve disappointed myself — that I had expected remarkable things of myself (certainly that’s how I felt as a kid, and even into my 30s) and that I’ve fallen short.
I find myself feeling jealous of the people my own age (or younger) who are now chairs or vice chairs, or who have risen to stellar heights in the Academy. And yet when I imagine being there, in their Birkenstocks, I realice I would still feel this way.
Which means I’ve set impossibly high expectations for myself. Not surprising considering that when I was a little pisher, I “knew” I’d someday win a Nobel Prize. (I’ve since learned that that is political, too.)
I need to take a deep breath and get back to the “good father, good husband, good doctor, good human being” definition of success. I think I stand a shot at that.
I wrote a lengthy post about universal healthcare and deleted it. You’re my friend and I shouldn’t get upset.
I’m sorry that you don’t feel as successful as some other doctors, but you’ve never struck me as a ‘chasing the dollar’ kind of guy. And that’s a GOOD thing. Quit knocking yourself for choosing relationships and good karma over cash.
how the FUCK did you get on indecision2008’s blogroll? AND whoa, what more do you need to define success? http://blog.indecision2008.com/
and yo, what is this “awaiting moderation” thing?
“I need to take a deep breath and get back to the good father, good husband, good doctor, good human being†definition of success.”
That’s an excellent plan.
Tam: how interesting. UH hater? Lover?
Yeah, like I said above, I don’t think it’s the money, either. If it had been, we wouldn’t have stayed so long in CC.
Kate R. I was a backer for their site when it first debuted. And I think one of the website admins took a shine to me. Which reminds me, I really ought to pimp their ride more. One hand washes, etc.
You used a new name, hence moderation.
Lucie: I know, I know.
UH hater.
I just look at all the multitude of things the government has ‘fixed’ for us that cost money, screw shit up, take away any form of choice, and just generally become a fuckaroo (HUD, Foodstamps, Welfare, Social Security, sub-prime housing, etc…) Medicare and Medicaid pretty much suck, so how in the world could UH care be better? As far as I can see, it’ll just be forcing pretty much everyone to be on title XIX. How is that good?
That’s all UH is going to be, more governmental BS that costs too much and actually does too little. After you wait for forever just to see someone at all, then be told that now you have to go see someone else to get another form, and they just tell you something different.
It’s the FREAKING GOVERNMENT! C’mon! What have they done RIGHT? What department is easy to deal with, is efficient, does what it says it’s going to, and doesn’t give you the ‘sit and spin’ run around until you’re ready to just give up?
I know out medical system is flawed, and I know a lot of people have a terrible time without insurance – fwiw, we went more than a decade without any so it’s not like I’m a primadonna or anything – and I know I don’t have the answers, I’m just really concerned about the government getting its grubby little fingers on one more thing that they’ll fuck up even more than it already is.
That’s one reason I backed Edwards in the caucuses. At least he wanted to give folks the same private insurance choices (and prices) that Congress gets instead of lumping the whole shebang into one big governmental pot o’ crap. Which is what we’re going to end up with.
Dammit.
That’s one of the reasons we backed Edwards, too.
One reason I’m a little more hopeful than you (a LITTLE, okay? Because I certainly share your concerns) is that I know they have some very bright minds working on this one. If UH turns out to be a shitstorm, it will be because the politicians screw it up. And yeah i realice that’s your point 🙂
Sorry, but I can’t agree that government effes everything up. How many people are ready to opt out of fire services? How many people are up for abolishing drivers licenses and just letting anyone drive? Licensing for physicians? Food safety? Air traffic control? True, highway construction could be privatized, but toll roads are frequently unpopular. Security services sort of substitute for police, but who’s going to pay for traffic cops?
It’s easy to object to government, but rarely do people actually say they want fewer services. Instead, the mandates are expanded out of proportion with the resources. What does that result in? Lots of stuff done on a shoestring and thus probably not done all that well. You want to save money, reduce the hours at the library. Hire fewer firemen.
Companies can and have outsourced everything from manufacturing to services to cheap labor markets, thus keeping costs down. The government cannot do that (imagine the squeals of indignation when Social Security sends everything to Bangalore).
Universal health care is not an easy one. When a good/service is free, people often use more than they need. Given the craven nature of many elected officials, who need to pander to the public every few years, who among them is going to admit that universal health care will not mean that every 90 year old granny gets a hip replacement and all the obsese will get stomach sleeves. Universal health care will, I believe, end up covering basic services (emergency room, pre-natal care, vaccinations, ear wax removal, etc) and not “fancy” stuff, since it won’t be affordable. The poor will get more. The rich will buy what they want. And the middle class will probably get less than those with insurance have now. Which is OK.
One last comment – the sub-prime mortgage crisis was in many ways caused by less regulation and less government involvement. Saying government is at fault really means one wants more intervention, not less. Or maybe I’m confusing government as an implementing agent with government as a legislating agent.
I meant the federal government – police, fire, drivers licenses and whatnot are state and local government which is much less prone to fuckaroo.
And I could be wrong, but I’ve read several places that the sub-prime crisis was because FEDERAL regulations demanded that loans for questionable housing and people with shaky credit were to be granted anyway in an effort to get these people homes! It’s to rebuild inner cities and give people stability! Everyone qualifies, regardless of credit history, or employment!
So – by my understanding – the government demanded that banks give loans that were known to be bad risks. The banks didn’t volunteer to give these crazy amortized, ballooning, too-big loans to people already in debt up to their armpits. The government said they had to, and now someone has to pay for it.