• Tag Archives medicine

  • Below Ground With Medicine

    Posted on by Charles Comment

    Spring                                                                Bee Hiving Moon

    On errands today I went to Mercy Hospital, got lost in their basement–think rooms filled with IV poles, wheel-chairs, book cases and beds–finally found my way to our Credit Union, then retreated, again through the basement, but knowing where I was going.

    On the way I passed the SEIU/Minnesota Nurse Assocation bulletin board.  On it were fliers to encourage documentation of management initiatives claiming to improve patient care, with the real goal of lowering staffing levels.  There was a very long document that related acuity of patient care with staffing needs.  There are struggles going on within medical care that are important for all of us, especially those of us concerned that folks have a decent wage and tolerable and safe working conditions.

    As I continued on down the hall, I noticed an Employee bulletin board.  On it were notices of apartments for rent close to the hospital, various kinds of services and, most ironically to me, two notices of fund-raisers.  Fund-raisers for what?  For costs associated with medical care.  Think of it, hospital employees, many of them making minimum wage or just a bit better, gathering with friends to support, with their health-care based salaries, the very system that makes access to itself not only expensive, but in some cases, impossible.

    Wandering around in various institutions is fun and educational.  Think I’ll hit the university next.


    📂This entry was posted in Politics 📎and tagged

  • Is There a Prophet In the House?

    Posted on by Charles Comment

    Lughnasa                                                                                                  New Harvest Moon

    NB: prophet is a gender neutral word as I use it.

    Kate.  Always ahead of her time.  When Kate was in high school in Nevada, Iowa, she arranged a deal to take most of her senior classes at nearby Iowa State.  She’d run out of classes in the high school, at least classes that could keep her interest.  In her senior year, just as the deal was to kick in, the high school changed their mind.  Later, as a nurse anesthetist, she insisted on better pay for her position at Mt. Sinai.

    After that, too long in the role of helper, she decided, at age 34, to go to medical school.  The medical school thought that since she was already a doctor’s wife, she should be happy with that.  She graduated and became a board certified pediatrician in the best medical delivery system in the US.

    After a serious illness and poor treatment at the hands of her then partners at Metropolitan Pediatrics, Kate moved to Allina, its Coon Rapids’ clinic.  While there she became frustrated with corporate medicine and chose to become lead physician for her group.  Over her time there she integrated pediatric and family practice offices, initiated (by doing it herself) after hours care and agitated for a better deal for primary care docs in general.

    Now, several years after she pioneered it, Coon Rapids’ peds has regular after hours clinic and the Clinic has an urgent care unit providing after hours non-emergency medicine.  Kate works in the urgent care, part-time.

    She has been tireless in haranguing me about the stupidity of pediatricians treating psychiatric problems for which they have little to no training. (see today’s Star-Tribune)  The arguments about vaccine that I read in this months Scientific American I first heard over the breakfast table.  She also campaigns against the overuses of anti-biotics, the over prescription of pain-killers and, most passionately of all, the need for a single-payer health system.  An equitable distribution of health care services has been at the top of her need list for a long time.

    She is a prophet in a system that, though excellent in its care, has become sclerotic in its administration.  The current over managed (way too many administrators with way too much power) model, corporate medicine as she styles it, focuses its efforts on the bottom line (money), on standardization (easier to manage), on patient satisfaction (results would be a better yardstick) and on turning physicians into employees.  Those who run these systems should listen to this practical, intelligent critic and change their ways.


    📂This entry was posted in Aging Family Health Politics 📎and tagged

  • More Art Than Science

    Posted on by Charles Comment

    Mid-Summer                                                                              Waxing Honey Flow Moon

    Gotta get back to those core exercises.  Back went ouch again today.  Sympathy for the Doctor?

    Healing is much less science and much more art.  Most of us see medicine covered in the glittering wrap of science, tested hypotheses, proven procedures, well-understood drugs, but in fact the science is often in deep background during a patient-physician encounter; where the most important work, diagnoses, is done often without the patient’s awareness.  Diagnoses, taking a given person with a particular list of symptoms and identifying what’s actually causing a problem, begins a this/not that path that then includes various treatment protocols.

    Will they work?  No certainty.  My former internist, Charlie Petersen, used to say, “We’re all  a bit of a black box inside.”  The difficulty faced by the physician is not only the variability in human bodies, but the inexact reporting of patients.  We often don’t know how to express ourselves to the doctor, aren’t always aware of what’s important and what’s not.  Ask anyone who thought that headache and funny vision would pass, then ended up in an ER getting treated for a stroke.

    I experienced this dilemma with Kona.  She presented with a right front leg held gingerly and a real grimacing when it moved.  I checked her front leg, feeling up and down its length, pressing at each point to see if there was a sprain or a break.  Nothing.  I felt no scars, found no blood.  I wasn’t sure what had happened but could find nothing wrong.  I never looked up and under her right shoulder where the wound was obvious.  I took her lead, followed the symptom she presented.  Doctors, of course, look beyond the first symptoms we present, but if we don’t mention something, they’ll not know to check.

    It occurred to me, given all this, that practicing medicine is an incredibly brave thing to do.  No one knows the limitations of western medicine more than physicians, yet they show up in exam rooms anyway, willing to use what they know to benefit the rest of us.  They work with us as knowledgeable experts, of course, but also as skilled listeners, both to our stories and our bodies.  The older I get the more respect I have for this, one of the oldest professions.


    📂This entry was posted in Health Humanities 📎and tagged

  • Gospel

    Posted on by Charles Comment

    Winter                                                          Waning Moon of the Cold Month    3 degrees

    In all the hoopla and aftermath of the party I forgot to mention the gospel.  The good news.  The friend’s wife I wrote about a couple of weeks ago, the one diagnosed with cancer?  She came to the party.  Not only that she said her energy was better than it had been for a while.  She looked good, too.  Both she and her husband looked still vulnerable, the residue of concern, fear lingering.  She has a hormone treatment, recommended by her oncologist, that may keep the cancer at bay.  Not cure it, but keep it from getting a firm grasp on her.

    As Leni said, another party goer that same night, about his throat cancer, “Well, you know, the goal now is to make cancer a chronic disease.  Something you can manage.”  He’s living proof, having survived in apparent good health for several years now.  He and the friend’s wife were not alone, either.  Hank, another party goer, has leukemia, a disease kept in check now for many years, so much so that it almost recedes into the background.

    These are the three I know about.  There were probably others.  Cancer no longer has the skull and cross-bones attached to its every appearance.  Think of it.  Cancer is not a new disease.  It killed people relentlessly in all centuries before the last one.  Now, it begins to look, at least in many cases, like the caged tiger, pacing back and forth within its chemical compound, its lethality imprisoned, though not rendered harmless.

    Kate has retired from the practice of medicine as others graduate each year to take up the responsibility, this tricky act we call healing.  It has more parts than chemistry and technology and knives, we know this, yet those parts themselves, the fruits of engineering and science, have a great deal to offer.  Perhaps this next century is the one where the enlightenment driven side of medicine will meet the ageless truths of the human spirit, joining together in a medicine, a healing for the whole person.   It may be that the last years of the baby boom generation, now upon us, will provide the impetus for this fusion.


    📂This entry was posted in Aging Faith and Spirituality Family Friends Health Retirement 📎and tagged

  • Hello Thunder, My Old Friend

    Posted on by Charles Comment

    Imbolc                                 Waning Wild Moon

    While eating breakfast this morning a loud noise, like a souped up street cleaner, disturbed my cereal.  I asked Kate what it was.  She thought it was a souped up street cleaner, or some other machine outside.  I got up to look.  It was rain.  Pouring rain, buckets, pummeling the roof.  The old snow will take a beating today.

    Then, another noise.  Thunder.  An old friend from the warmer seasons.  On your marks, get set, grow.

    Kate and I began our 21st year last night at midnight.  Another growing season has begun to push its way toward us, too.  As we celebrate events this year, birthdays, anniversaries, holidays, the growing season, each one gets punctuated with, When we (do this next), you’ll be retired.  This is Kate’s last year at Allina, and she will not be sad to let go.  Medicine has changed and not in a good way.


    📂This entry was posted in Family Weather +Climate 📎and tagged

  • Sandwich a Bio-Hazard?

    Posted on by Charles Comment

    Imbolc                                        Waning Wild Moon

    Those in the health care world, at least the care provider part of it, use medical in a way most of us lay folk don’t.  They ask people they meet, especially spouses like me, if they’re “medical.”  Kate payed me a compliment in this vernacular a few months back by saying, “He probably doesn’t realize how medical you are.”

    What does it mean?  In part it means a familiarity with the everyday life of medicine, that is, a life dealing with blood, sputum, questions about constipation or overactive bladders, stitching up wounds or struggling with life or death in a code blue type situation.  I sense, too, that it refers to an acceptance of the brute facts of life.  Illness and trauma happen and they happen to all sorts of people at all sorts of times in their lives.

    At some point the news can be bad, “He didn’t make it.” or “You have lung cancer.” kind of bad.  They also know, better than most of us, that death comes in many forms and that it comes to us all.  There is a contradiction here; however, since contemporary medicine sees death as the enemy and procedural medicine as their chief weapons in this apocalyptic struggle.  I use the word apocalyptic here in reference to the universe that dies with each person.

    Medical also means going into the refrigerator for something to eat, taking what looks like a sandwich in a ziploc bag and discovering the container says:  Specimen Transport Bag and has the red and black bio-hazard emblem with BIOHAZARD written in bold black letters against the red field.

    Being medical does put you in a world different from the day to day, where we consider normality health, enjoy a certain consistency to our routine and find trauma or illness an upsetting deviation.  It’s been a privilege, this past 20 years, to learn about it from the inside.


    📂This entry was posted in Family GeekWorld Health Humor 📎and tagged

  • A Pleasant and Substantial Path

    Posted on by Charles Comment

    70  bar steady 30.13  0mpn SSE dew-point 62  sunrise 6:16 sunset 8:17  Lughnasa

    Full Corn Moon  moonrise 2014    moonset  0554

    “Mistakes are at the very base of human thought … feeding the structure like root nodules. If we were not provided with the knack of being wrong, we could never get anything useful done.” – Lewis Thomas

    Had to call the generator guys yesterday.  Our Kohler should exercise itself every two weeks, Tuesdays at 11:00 AM.  It has not done that since installation.  It works, we know that because it turned on during a power outage in June.  The exercise cycle, however, is how we know it works in between storms.   A fail safe.  They had a reason this time, like they had the last time.  This time use during an outage kicks it off the exercise cycle, “A problem Kohler refuses to recognize.”  The first time it was air in the gas line.  Maybe so both times, but I want it to do what we paid a hefty sum to do and that includes letting us know it works, all the time.  Otherwise, come an outage we may have no power and an expensive lump of metal and wires to help us enjoy the darkness and the heat.

    Today and tomorrow and Monday are prep days for the herds migration out to our place.  Groceries.  Garden spruce up.  Hydroponics restart.  Decluttering the living room and kitchen.  That sort of thing.

    Kate’s last two years of medicine are not the gentle glide down to a soft landing and out I wish they could be.  Her style of practice and the newer, corporate style do not mesh; the gears grind and jump.  It means she’s under pressure to see more patients, see more adults and smile doing it.  She needs a union, at best she will get out with her dignity intact.

    We have, however, set ourselves on a pleasant and substantial path here at home.  We have expanded food production here this year and will expand again next year and possibly the year after that.  There are energy capture projects I have in mind and much more to learn from the disciplines of permaculture and horticulture.  She has her sewing and quilting; I have writing and politics.  Together, too, we have the kids, the grandkids and the dogs.  She will be here longer than she will be at work.


    📂This entry was posted in Family Garden Great Work 📎and tagged

  • Back to the Shang Dynasty

    Posted on by Charles Comment

    31  bar rises 30.24 4mph ENE dewpoint 13

                 Full Moon of Winds

    A visit to the dermatologist.  Oh, boy.  Talk about quick.  He looked at my elbows, looked at my knees, looked at my face.  He said don’t use the steriods too much–I never do–and give yourself a week vacation from them every three weeks–new information–and come back in a year.  Good-bye.  Wish all medicine was as clear and effecient.

    I’ve begun my reading on Chinese bronzes.  I’d forgotten that the early bronzes imitated ceramic shapes and decoration and were then superceded by painted lacquer and, eventually, stimulated ceramic imitations. 

    Received an invitation to the Chinese New Years dinner that the Chinese CIF folks put on each year.  I love to go because it gives me a chance to reconnect with my CIF friends.  This year I hope to get a tutor in Chinese pronounciation from among them.

    This event will be in the Lauderdale City Hall.  Lauderdale is a blip on the geography of the Twin Cities located between 280 and the UofM golf-course on Larpenter.  And it has city hall.  Imagine.

    Well, back to the Shang dynasty.


    📂This entry was posted in Art and Culture 📎and tagged