1984

So, it seems that while I wasn't looking, our government went from mildly unnerving to downright terrifying. Or, well, I guess it was always pretty terrifying, the Patriot Act not being a new thing and we only just found out about it?


In any case, it appears that the government is now able to (and has been for a while) track who you're calling though, according to Newshour, not the actual contents of your calls. Still, “Holy slippery slope to a scary distopian future Batman!” (you have to say it really fast, otherwise it doesn't work).


The irreverent part of me wants to suggest that the “They're going to take all our guns,” conspiracy theories from the right are in and of themselves a conspiracy to distract us from this actual bid to compromise our liberty (and it's working). The regular parts of me are all just scared.


There's a cool article on NPR right now discussing the correlations between this (not so new) legislation and both Orwell's 1984 and the writings of Franz Kafka. I haven't read any of the source material but I have read plenty of articles comparing every damn thing to Orwell's 1984. I have to say that the correlations pointed out in the article are quite startling. There's much less scare mongering and many more actual lines of similarity. It makes me wonder where this country is headed and if that's a place any of us want to go.


In any case, this is one of those subjects that I (currently) lack the knowledge or experience to judge and I'm off to read Orwell's 1984 and Kafka's Great Wall of China (which must have an English translation somewhere I'd have to think). While I'm at it I'd probably better read the actual text of the Patriot Act pertaining to my questions and maybe even the whole of the president's speech. Good thing it's summer vacation.

The Death of Retirement?

Skimming the PBS Newshour site, since I haven't been making their podcasts a priority like I ought, I encountered the introduction for their soon to begin series Will You Work Forever? and it piqued my curiosity.

The series promises to use personal profiles of Americans who reentered the workforce after retirement or never retired at all, coupled, I expect, with Newshour's trademark warm touch, to look into retirement in our changing economy and the effect of the broken housing bubble on people's best laid plans.

Personally, I'm terribly young to have and opinion on retirement and I don't know how relevant my opinion can really be but here's my take, I'm poor, I grew up poor and practically everyone I know is poor. I have little practical experience (outside of what I've gleaned from the media) with retirement. Not only that, I started college pretty late in life and, not to put too fine a point on it, have worked my ass off to get to a place where I can have a real, interesting, grown up career, whether it's in the medical field or not. I can't see myself working said career for only a decade or two before saying, “Ciao, I'm off to travel the country!” or whatever it is that retired people do. Besides, do people ever actually stop sciencing? Why would you do that? I'm going to continue with my impression that scientists stay in their labs until they expire from either old age or an experiment gone wrong.

Anyway, I personally never expected to retire, but it leads me to wonder for those who do or did look forward to retirement, is this a symptom of the death of the middle class. Is that even a thing or was it made up by the media? Has the divide widened to the point where a person is either set for life or must work until they die?

I suppose, historically, retirement for the middle class and the poor is a novel idea. Not so log ago (before the Great War? Correct me if I'm wrong please.) the poor expected to work long hours either at home, in the fields or, after the Industrial Revolution, in factories from the time they were old enough to walk until they were too old to get around. Was the time period where retirement was a thing only a brief honeymoon period in history that's now coming to an end or does its loss signal a deep systemic problem in our society and/or economy?

I also question whether this extended time in the workforce will be allowed by employers who may not want the burden of older, sicker workers (though time missed could be made up by an older employee's greater experience and efficiency) and more expensive health insurance premiums. Will his shift ultimately help our economy by providing more efficient, experienced workers or will it cripple it as those of retirement age hold jobs that would have otherwise passed on to the next generation?

I certainly look forward to the new series.

Introspection...

...and possibly a change in plans.

I suppose that merits an explanation since I started this blog then abandoned it for three full years. I started college as planned and showed steady progress. I even took classes every summer and loved them. Everything was going really well until my husband and I decided to have our fifth and final baby.

I thought I could handle the pressure (along with the full time job I'd picked up that semester) without a drop in my grades. I was wrong. The fact is, I failed every class this last fall with the exception of Calculus and this past spring I did little better than average in all my classes. This puts med. school... off. Actually, it pretty much takes med. school off the table..

So... now what? It's time for some of that introspection. What do I want to be when I grow up? Over the past few years, I've often made the joke that if I can't get into med. school I'll just have to run off and become a geneticist or a chemist (insert fake sad face and exaggerated tone of woe). Neither of those things (or cell biologist, or physicist, etc) sounds bad. I'm sure I'd love any job I managed to get as long as it's in the sciences but the letdown is hard. I was so determined, so sure that I could do it. Despite all the disadvantages, poverty, a bunch of kids, the fact that I never finished high school I thought I could do it. I was just that damn smart. I was special. Turns out, I'm not that special. I've learned that if I can't attend the class, I can't ace the class. I can barely get a C. I'm not even really sure that textbooks were meant to be used the way I've been using them, as your only source of info as opposed to as a supplement for the lecture.

In any case, I'm stuck here for a while. I'm taking the summer off to spend some time with my kids and my beautiful new baby. I'm taking no classes and my goals are a refreshing change of pace. I plan to blog five days a week and write another novel (at an hour a day five days a week). I also plan to learn Statistics and Multivariate Calculus (both of which I wanted to take at the college but just don't have the credits for) using textbooks and Khan Academy.

Other than that, I need to take this time to just breathe a bit and reevaluate my goals. I've learned a lot about myself in college. I'll never, for example, be really happy as a stay at home mom, I love the sciences and I'm passionate about research. Now I just need to put all that information together and use it to build a brand new vision for the future. Easy peasy, right?

Kate's Birth Story

I walked into the hospital on a cool afternoon late in May. My bag was packed, my membranes had been ruptured for almost two hours, and my baby's head was firmly lodged in my ribs where it had stubbornly remained for the latter half of my pregnancy despite an attempted version and all the woo I could throw at the poor little baby.

On that blustery afternoon, I was by far the most pregnant I had ever been. I was also (understandably) apprehensive. This would be my fifth live birth and up to this point I had birthed babies every which way but medicated. I'd had two unmedicated vaginal births, one unmedicated VBAC and a miracle of an emergency c-section (at 29 weeks) that left me more mentally than physically scarred. I was afraid walking in. Afraid not of the surgery itself but that I would panic going into it and miss the beautiful moment that my baby was born.

We skipped triage. The nurse took one look at me and the hand towel I was wearing as a pad and declared me grossly ruptured before escorting me back to a labor/delivery/postpartum room. It was a Sunday and my ob was both not on call and out of town so while we waited for the on call doc. the nurse did my intake and my husband braided my hair to keep it from bothering me during surgery and the immediate recovery.

The anesthesiologist came in to check me out and between checking for airway accessibility and basic pre-surgery questions we bonded over the hell that is Vertebrate Anatomy, a class I had passed only two weeks before. 

 

Everything checked out and as soon as the attending ob arrived, I was wheeled the very short distance down the hall to the O.R.

I'm really surprised at myself writing this because I never thought that I would feel this way. My c-section, the one that I walked into with such trepidation, turned out to be the favorite of my five births. I hopped up on the table and the anesthesiologist, upon seeing my surely obvious nerves showed a stroke of brilliance and began walking me through the procedure step by step using all the big sciency words that I love so much. He ran me through the whole procedure and then when he ran out of (non-alarming) things to explain about a spinal began comparing it to an epidural. I'll admit that I was so fascinated I didn't even realize that the doctor had started cutting until my husband started breathlessly walking me through the baby's delivery by body part. I almost died when they told me that we'd had a girl. They took her, suctioned out her lungs and weighed her.

Katherine Jamethiel was born May, 20th 2013. She  weighed 6lbs, 8oz and was 20 inches long. She joined me for my recovery in the very same room we'd started out in after a brief 45 minute NICU stay for breathing difficulties typical of both breech and c-section babies. She was a breathtaking, perfect little girl.

None of this sounds all that special or momentous and, to be honest, it was a pretty average, everyday birth. I remember it though. Every little moment. I didn't with my other kids. When I gave birth this final time I felt safe and calm and well taken care of.

Natural birth is great, it's a rush, but it's also fast and dirty and painful and overwhelming and I'm so, so grateful that, just this once, I don't have to rely on someone else to tell me my baby's birth story.

I'm Gonna Die...

... and college will surely be the cause. Week three of classes has just begun and already I'm running on caffeine, adrenaline, and despair.

So far, I've had three homework assignments, one exam (on which I scored a rocking C, due to my intellect's embarrassing defeat at the hands of a ScanTron sheet), and eleventy-gazillion pages of reading material.

Deep breaths. I can do this. In the words of... well I don't know who said it, "Failure is not an option." Really not.

I've got to get these things done and I've got to get A's on them, because, I don't want to be a biologist. I want to be a doctor and you don't get into med school with C's.

Success or Death!

***
In other news; I'm taking a Health Care Mega-Trends class, which is retarded.

I thought, first of all, that my proffessor would exert at least some, small modicum of effort to appear neutral, but no such luck.

Let me preface this rant with the fact that I know, without a shadow of a doubt, that our health care system is broken.

I'm just not entirely sure that Obamacare (I'm sorry, the Affordable Healthcare Act) is the best way to go. I'm certainly not going to go out on a limb and say that it's the only way to go.

The textbooks I've got to read for this class are unbelievably biased and one of them is out of print (Who assigns out of print books as textbooks anyway?).

But, the free market system won't fix our health care system, squeal my textbooks. We've tried that before and it didn't work!

No. We haven't.

First of all, we've never tried a free market system. You know, with price transparency and interstate competition for health insurance companies (among other things)? So don't tell me that we tried it and it didn't work.

Second of all, even assuming that a free market system wouldn't fix a majority of the problems in our health care system, how is the Affordable Care Act the only good solution? What about a single payer system (Eeek! Socialized medicine!) Hell, it works for a whole lot of other developed nations around the world. What makes us so different?

But they'll kill off our old people in giant concentration camps like the Nazi's! I hear you say.

First of all, that brings up opinions on certain end of life issues that I know I don't share with a majority of Americans (although none of them involve concentration camps for old people) so I won't get into that. Second of all, no. No they won't. Let's not be stupid. No one advocating for a single payer health care system is suggesting that you ship grandma off to the Old People Resort, Spa, and Death Camp (TM). Nor is any (sane) economic or political forecaster predicting any such thing. Do they kill off their elderly in Canada? How 'bout the Netherlands? Great Britain?

Seriously, lets get real for a minute here. Would there be some "rationing" of care? Of course there would. Rationing care is the only reasonable way to provide care for everyone. You fractured your tailbone (please note: this is only an example) and now, you'll have to wait a week or so to get it repaired. I'm sorry, the orthopedists in your area are busy repairing spines. Think I sound heartless? Think about how you sound, when you whine about that sprained knee that needs to be checked, to a person that's had to walk around (and go to work) for the last five years with a broken back.

But who would make the decisions about who gets care right now and who has to wait? You ask.

Doctors.

Yes, that's what I said. Get over it, all you whiny, mealy-mouthed, members of our public who scream about how our average joe is just as good as any doctor out there. They are fully as valuable, as people, but they are not on the same level professionally. Doctors are in a special position where they have acquired a vast amount of knowledge from specialized schools, training, and work experience in caring for people with medical conditions, that we, as the general public, are not. Don't like it? Take a shot at med school and practice for a few years. Then you can make your own judgment calls about who can and cannot (or should and should not) be treated and/or saved.

Doctors, not elected officials, not bean counting bureaucrats, would need to be the ones to make the calls. Heck, appoint, or even elect, a panel of them that the public can appeal to.

I don't see why this idea causes such a problem for some people. Most people don't do their own taxes, fix their own cars, or cut their own hair, so why the hell do they leave these matters to experts (who went to school to learn their trades) but expect to know better than medical practitioners about health care? I'd bet your doctor doesn't fix his own computer.

***

All right, I'm done for now (I think) although I'm sure there'll be more to come. I feel a posts about end of life issues and HIPPA coming on as we speak, but my Biology notes are calling to me so I'd better go.

Tort Reform -Why Doctors Can't Say They're Sorry

Lately I’ve been doing some reading about the myriad of things in our healthcare system that we could be doing much better and as always tort reform comes out close to the top.

Looking at it, the problem doesn’t only lie in our rising medical costs due to malpractice insurance and doctors practicing defensive medicine (ordering probably unnecessary tests and treatment out of fear that they might get sued). It also erodes the trust present in the doctor-patient relationship and the integrity of the doctors forced to practice in a litigious atmosphere.

Doctors aren’t allowed to say “I’m sorry”. It’s a malpractice thing, kind of like the warning on the back of your car insurance card that says, in event of an accident don’t apologize. Apologies imply guilt, you see, and guilt means you lose in court.

The strange thing is that, they found (in a study I can’t lay my hands on right now), that if the doctor had only apologized, most of these lawsuits wouldn’t have happened. These lawsuits are brought to court by people in pain. People that have just lost a loved one, or a leg. People who believe that the doctor should be made to pay for what they’ve done since they so obviously have no remorse.

Can you imagine? I’m sure it’s happened to most physicians at one point or another, whether as a near miss or a true tragedy. One day you screw up. You’re too tired and you make a mistake during surgery, you misdiagnose a condition because the alternative just didn’t occur to you, someone dies or is horribly disfigured. And you can’t say, “I’m so sorry. I was tired. I didn’t think. I was human. There’s no way I could ever make up for your loss.”

What does that do to them as people? Doesn’t it make them feel like a monsters to cause a tragedy by making a mistake and then have to consider something so ridiculously pragmatic as whether or not the family will sue? How hard is it to go against their first instinct to try and ease these people’s pain and lock it down so that they can pray they don’t get sued. It’s a challenge with a million dollar price tag if they fail.

What does it do to the doctor-patient relationship when there’s a bad outcome and you know that even if your doctor was in the wrong they wouldn’t tell you? It sure makes it easier to assume that there was a mistake and a cover up or even true malicious intent, doesn’t it?

How did we get here? To place where people in pain use the legal system to punish people in pain? Who can fix this, really? What can we do? I don’t have the answers to any of these questions. Maybe someday I will. But for now I think we need to start by asking the questions.

It's Hard To Get Into Med School

I’m shocked, aren’t you? It’d be more amusing except that really I am, kind of. I thought that all you needed were good grades (really good, like 4.0 good) and a decent score on your MCAT (the SAT’s of med school). It turns out that this is not so. You also need a good amount of physician shadowing, 500+ hours of volunteer work (yes over five hundred. Yikes!) in a clinical setting and “well rounded extra-curricular activities”.

So basically I have to get a 4.0 in a “well rounded” (not just sciences) degree, ace my MCAT, convince several doctors to let me follow them around for a while, offer myself up for ten hours a week of indentured servitude for a year, and join, ugh, clubs.

All I have to say, is that they must really want to make sure that you really want to be a doctor. And that you handle pressure well. As far as I can tell, the schedule imposed by the volunteer work plus school and school related activities (classes, homework, clubs, and work study) AND the care and feeding of my spouse and four children will leave me with approximately six hours a week of free time to do things like, you know, read a novel or poop. Did I mention that medical school and residency are supposed to be much worse than this? I think that they have about this same schedule only without sleeping during the week.

I’m glad I found the Flylady system which works uber awesome for me. It’s the only way I have a prayer of keeping up with school, getting my homework done and keeping my house from being condemned. I strongly suggest that everyone check it out. Just be sure to take some of the over-the-top sappy messages with a grain of salt. I, for one, can’t help but snicker at terms like, “weekly home blessing hour” (that’s when you do things like change your sheets) and quotes like, “Nothing says I love you like a clean toilet to throw up in!” You should definitely check it out, just don’t drink the Kool-Aid.

In unrelated news, my brother got married yesterday in a beautiful ceremony that just made me wish harder for one of my own. Fortunately my divorce (from a man I separated from nearly a decade ago) should be final by the end of September which means that I can finally marry the wonderful man that I cohabitate with, although I still don’t get a gorgeous ceremony or a pretty dress. Such is life I suppose.

I’ll post pictures of the ceremony regardless, because, well, I’m pretty proud of myself for finally having the courage to get divorced. It took me a long time. Heck, starting school, getting divorced, VBACing my fourth baby. This year seems to be all about courage for me. It’s certainly filled with new experiences.

Well, I should probably run along and put an end to the Wrestle Mania going on in my living room. Be sure to tune in… well, tomorrow to read about the awesome volunteer job I nailed over at our local hospital.