So far I
have heeded Neal
Pollack's advice to Shut Up
but I've got to admit, this is better than television. Why wade
through hours and hours of mind-numbing shit when I can just make
my own in a fraction of the time and post it on the net whenever I
feel like it. This is the future, folks. The asymptotic
signal-to-noise ratio.
But at least I have decided to separate all my
anti-Bush, anti-War-on-Iraq, anti-imperialist, anti-racist,
anti-corporation,
anti-rich-people-who-don't-care-about-the-rest-of-the-world
diatribes from my main blog. That, I am
reserving for documenting my pathetic love life or more accurately,
the lack thereof.
So what inspired me was a discussion about the
impending invasion and occupation of Iraq I was having with a peds
cards attending (I am going to introduce you all to the wonderful
shorthand, acronyms, and neologisms of medicine. Engineers have got
nothing on us. Peds = pediatrics. Cards = cardiology. Attending =
attending physician, i.e., the guy who gets sued when something
goes wrong) Well, considering that I am a lowly medical student
whose continued existence as such depends entirely on evaluations
by attendings, you can guess that calling it a discussion is pretty
generous. OK, fine, it was more of a lecture.
But he is a well-educated man, more in touch with the
outside world than many of us floundering around in this ballyhooed
discipline of ours, and he made a lot of good points.
War is a lot like surgery. His argument is that no
reasonable person can really be completely against war, anymore
than any reasonable doctor can be completely against surgery. There
are instances where you have to go to war. Like when Hitler
is trying to eat the world, or when Japanese Imperial soldiers have
taken over your village and have decided to bayonet a random person
every day of the week for shits and giggles. I have no qualms about
that. In the same vein, no doc in their right mind would recommend
antibiotics when a kid has appendicitis. That kid is going straight
to the OR (OR = operating room), no questions asked. You cannot
really try diplomacy when someone is bombing the hell out of your
city and won't stop until everyone is absolutely dead or at least
enslaved.
But the thing is, some of us here think that this is
really more of a cosmetic procedure than an emergency. (There are
far more emergent and urgent things that W needs to get done here.
For now, I will defer discussing the facts that we know
North Korea has weapons of mass destruction capable of reaching
West Coast targets, that the Venezuelan economy is collapsing
causing oil prices to skyrocket, that health care will soon cease
to be viable in the U.S., or that Medicare and Social Security will
all be completely bankrupt very soon at the rate we're going.) Add
to this the fact that the patient (i.e., the world) has not signed
the consent form, the
OR has not been properly prepped and the surgical team is
underprepared and that the clinical findings are extremely
equivocal and we haven't finished the workup to confirm that there
is actually an infection (i.e., no one has proven that Iraq has
chemical and biological weapons, and if they've been stable for 12
years, why in the hell would it suddenly turn into an emergency
today?)
So you see where we're at right now. I mean, you can't
operate without proper justification. It doesn't matter if you end
up saving the patient's life. Without the workup and proper
documentation, more likely than not, the insurance company will not
pay you. (OK, so maybe this is more a flaw of the health care
system than a good analogy, but you get the picture.) Show us the
bombs and the missiles. Then maybe we'll go along. Right now, we'd
be operating on the gist of a rumor, as far as I'm concerned. It's
stupid. We're going to risk our soldiers (and this is a
known risk! Far more Americans were killed by other
Americans than by Iraqis during the first Gulf War) for what may be
a mission of political convenience rather than life-or-death
necessity.
I mean, yeah, there are indeed thoughtless people out
there who are protesting just to protest, and who don't really have
strong convictions, but I think the more intelligent of us war
protesters have really thought this through, and until more
evidence comes in, as of now, it seems completely wrong. They
haven't convinced the American public and the world that this is in
fact a surgical case, and they haven't given medical management a
chance to work yet.
I mean, seriously, with the cost of malpractice and
all, if I were a surgeon, and the findings were equivocal, I would
sure as hell not operate unless I was absolutely convinced that to
not operate would cost the patient his or her life. Sure, right
now, I'm not the guy behind the blade, but hell, if I were, I would
not be convinced.
Seriously, can you imagine a dialogue like this?
Surgeon: We need to take you up to the OR stat
Patient: Why?! What do I have?
Surgeon: We don't know. We think that it's a really big tumor
that we need to cut out right now. I know that you've probably had
it for 12 years, that you've been completely stable with
chemotherapy and radiation, that you're not even really that sick,
and that if we do the procedure right now before we give the chemo
and radiation a chance to work, there's a 100% chance that you will
lose some function of your legs. Still, a few years of physical
therapy will probably allow you to function just like you are right
now. I haven't looked at the labs or the CT scan, but we need to do
it right now, in five minutes.
Patient: What?! What do you mean you don't know? What do you
mean, you think? You quack! I demand to be transferred!
I swear, we should be able to sue politicians when they
make mistakes the same way we can sue our doctors when they make
mistakes.