My first blog was back in March 2006 and I have been here intermittently ever since.  My one successful post involved Sarah Palin and Amniotic Fluid.  I just figured out the reader blogs are going away so I wanted to say goodbye.  Not sure anyone will read this, but thanks to all for some very good writing over the years.

Take Care!

I am going to collect the following books and burn them:

One Bible
One Torah
One Book of Mormon
One Koran
One Satanic Bible
One copy of Dianetics
One Tao Te Ching
One Kama Sutra
One of the books that Hindus read
One of the books the Buddhists read

and
One Marijuana Cigarette (Rastafarian)


Alas, I cannot burn every single religious book on Planet Earth.  Humans would be better off without religion.  At least I can imagine that...

addendum: Also need to throw in a Christopher Hitchens and a Sam Harris book too, Atheism is just another religion

I just wanted to express my admiration for New York Mayor Michael Bloomberg.  I wish he were the current US President.  He is the only politician who seems to make any sense lately.

When future historians look back and try to determine when the United States changed from a democratic republic to an oligarchy, Jan 21, 2010 will be a very important day.  It was the beginning of the end of the middle class in America.

Our government is now officially for sale thanks to the Supreme Court.  Even though Congress no longer actually represents the interests of the people, they will no longer have to bother with the charade of pretense.  

Banks are now free to run amok.  The will put the loan-sharks out of business.  Bankruptcy is no longer a salvation for those in trouble.  Health-care will be rationed by corporate executives.

Organized crime has gone global and corporate.  

No one will be able to stop it.

Our current president and congress, ruled by democrats, will not be our savior.  The words "Democrat" and "Republican" will soon be as meaningful as "Whig" and "Federalist."

Dark days indeed...

I know everyone is pretty angry with Joe Lieberman, he seems to have a textbook case of narcissistic personality disorder.  He is about as mature as a teenager on prom night.  However, is he really to blame for killing the public option and medicare buy-in?  Or is that what we are supposed to think.  Has he merely been acting the role of Judas?  When viewing political events these days, most people barely look beyond the surface before reacting anymore. 

This is not something I figured out myself.  I would like to recommend reading a post by Glenn Greenwald.  I am sure most of the readers here are familiar with his writing, but this article is particularly insightful.

White House as helpless victim on healthcare

Here is a brief excerpt:

In an ideal world, Congress would be -- and should be -- an autonomous branch of government, exercising judgment independent of the White House's influence, but that's not the world we live in.  Does anyone actually believe that Rahm Emanuel (who built his career on industry support for the Party and jamming "centrist" bills through Congress with the support of Blue Dogs) and Barack Obama (who attached himself to Joe Lieberman when arriving in the Senate, repeatedly proved himself receptive to "centrist" compromises, had a campaign funded by corporate interests, and is now the leader of a vast funding and political infrastructure) were the helpless victims of those same forces?

I agree with Howard Dean.  This has become a bad bill and will help insurance companies more than the insured.


addendum:

A few more quick points to ponder -

1. This bill mandates that all people can obtain insurance without regard to pre-existing conditions, but does nothing to control the potential price of these policies to any reasonable level (I believe it can be as high as 300% of the lowest premium)

2. It does absolutely nothing to address the shortage of primary care physicians.  This shortage will continue to worsen for at least the next four to five years based on the number of physicians currently in residency training.  What good is insurance if you can't see a doctor?

Does anyone remember Sgt. John Russell?  He shot and killed five US soldiers at Camp Liberty in May 2009.  He killed his psychologist.  It was big news for a couple days, but now you can barely find it on the web.

Lapses Found in Case of Sgt. John Russell

I have read many articles about Sgt. Russell, but I still have no knowledge of his religious beliefs.

US soldiers are facing an epidemic of suicides.  The current model of sending the same people back to tours of duty in war zones time and time again is a disaster.  If your goal was to create PTSD in your troops, this would be the recipe. 

Doctors in the military are pressured to clear people to return to combat duty.  However, it actually doesn't matter whether the physician has cleared the soldier or not, as the ultimate decision is made by the commanding officer. 

In particular, when I was active duty I refused to clear a sergeant to go to Iraq due to ongoing medical problems.  That's when I found out it didn't matter what I, his doctor, had to say about his medical condition.  His commander felt his condition was not serious enough, so off he went to Iraq.  He barely lasted two weeks until he was sent back.  I received an angry phone call from his physician in Iraq asking why I had cleared someone not fit for duty.  I got angry right back, told her to read the damn paperwork, and promptly hung up on her.  When this soldier returned stateside he was promptly discharged by a medical board. 

I don't know about the rest of the military, but from what I saw during my time, the medical corps is run by incompetent fools.  Physicians in the military don't have the necessary autonomy to provide excellent medical treatment.

But religion does?

It has been over twenty four hours since another mass murder in the US involving a lone gunman.  However, there has barely been any mention of gun control.  And there are some would have us bring back the Japanese internment camps of WW2, but this time fill them with Muslim US citizens.  I just don't understand what is wrong with the US.  Guns, especially handguns, are designed to kill people.  Religion, while responsible for many deaths throughout history, was essentially designed to save people.  Why do we fear religion, but not guns?

I shared a bit of my experience in the military with my last post, but I have another memory I wish to share.  Even though I was commissioned in the military many years before 9/11, my first week of extended active duty was actually the first week of September, 2001.  I was in a large group of doctors undergoing training before we headed off to our first duty assignment.  We watched 9/11 on the television in our classrooms while our base was on lockdown.  During the next few days we didn't do much, we were on a training base and couldn't go anywhere.  After a few days, when we knew the Taliban and Al Queda were responsible, one of the members of our group stood up to make an announcement.  He was a radiologist who was born in Pakistan, and he was a muslim.  He was a US citizen.  His wife was also going through training with us, and she was also a muslim.  He asked to address the class and he did so in a pained voice full of anguish.  He tried to explain to this group of military doctors that Islam was not violent.  The terrorists who attacked us were not representative of his religion.  I admired this man for his courage, but I fear he probably had a difficult time in the military. 

When I got to my first base, my commanding officer was a very devout christian of a traditional sect.  He regularly sent out emails about Christianity.  As the war in Afghanistan grinded on and the Iraq invasion started, many people I worked with made discouraging remarks about muslims openly.  We had prayers before informal meetings.  As a long-time agnostic this environment made me profoundly uncomfortable.

This latest incident has really gotten under my skin, but I feel powerless to do anything.  I also feel a lot of anger that a person can purchase a weapon which allows them to kill and injure so many people.

Nidal Malik Hasan was an Army Psychiatrist.  Although I did not know him, I thought I could provide general background about what his career and service obligations were, and I can also share personal experience of being a doctor in the military.  

He graduated in 1997 with a degree in biochemistry and was in the ROTC.  He then went to the Uniformed Services University of Health Sciences (USUHS) in Bethesda, MD.  He graduated from medical school in 2001 (medical school is 4 years).  He then did his residency in psychiatry at Walter Reed (5 years for residency).  He most likely finished that in 2006.  At that point he would have been on active duty at least 9 years, and most likely owed at least seven, and perhaps 9 years more before he would be released.  Medical school at USUHS confers a 7 year commitment, and he may have had extra time for residency.  

I served for four years in the Air Force as a  physician, but I was trained at civilian institutions.  My four year obligation was incurred as a result of the military financing most of my civilian medical education.  Roughly 75 percent of the doctors I worked with hated being in the military and were just biding their time until they could get out.  We were under immense pressure from all sides.  It was extremely difficult to even give average medical care.  Usually you had to settle for less than standard care just to remain sane.  It was an incredibly stressful situation.  I worked with a few good physicians, but in general, military physicians have a different philosophy.  The command structure of the Medical Corps is extremely dysfunctional.

It was much harder for the USUHS grads because they had a longer obligation.  Although many of us were unhappy, there was virtually no way to get out early without ruining your medical career.  For example, there was no option to get out and repay the military for the cost of your education.

After I separated (got out), I heard one of the doctors I worked with allegedly threatened to bring a gun to work and shoot the commander.  I never heard what happened to him, but he probably lost his medical license at the very least.

This doctor must have been under a great deal of stress.  He served at at Walter Reed during the time it was receiving extremely bad publicity in the national press.  He was probably dealing with extra pressure because of the national scrutiny.    I would speculate that he was depressed, suicidal, and must have felt so isolated and hopeless that he saw no other way out.  It is still shocking that he would chose such an abhorrent action. 

Yesterday, a condemned inmate in Ohio won a delay of sentence for "cruel and unusual" punishment.  It seems the technicians spent over two hours trying to find a suitable vein to insert an intravenous catheter without success.  It is difficult to find suitable veins in people who have previously abused IV drugs.  The judge granted a ten day stay.

However, what this prisoner experienced is really not that much different than what many patients have experienced in a hospital intensive care unit.  While starting an IV can hurt, starting a central line or a inserting a catheter to perform a cardiac catheterization is also painful. 

This judgment sets a dangerous precedent, what if a patient decides to sue their doctor for torture?

One of the difficulties that prisons face is trying to find appropriately trained personnel to insert IV's into condemned prisoners.  Most (if not all) state medical licensing boards prohibit physicians and other medical personnel from participating in executions.  This means the most experienced people cannot help when difficulty is encountered in starting an IV.  Perhaps the prisons can hire a retired or unlicensed physician as a consultant for IV access during executions.

There is certainly nothing cruel about starting an IV.  This inmate must have injected himself many times in the past directly in his veins.  So this is neither cruel nor unusual. 

The best idea I ever heard for executing prisoners would be to put them in a chamber and fill it with pure nitrogen.  That would be safe (for those observing), effective, pain-free and cheap.

He graduated before I started, but he is still listed as a faculty member at the University of South Florida College of Medicine in Tampa, FL.

Neurosurgeons are very rare and important specialists.  But to think that more than a select few of them has any clue about what is going on with the Big Picture in Healthcare is ludicrous.  A good neurosurgeon is rarely seen outside the hospital.  They are also on the upper end of the doctor pay scale so they have a keen interest in remaining at the top.  I am sure they all hate managed care.

You can find public information about Dr. McKalip here.
Just type in his last name in the search box.

Interesting note -- he doesn't carry malpractice insurance.  He also accepts medicaid.  Draw your own conclusions about that...

I would recommend letting the administration at USF know what you think about one of their faculty members emailing such a blatantly racist piece of propaganda. 

You can contact the USF College of Medicine Dean here

Stephen K. Klasko, MD, MBA
Dean, College of Medicine
Vice President for USF Health
sklasko@health.usf.edu

Click here for USF Health contact page

Contact the Professional Integrity Office at USF here: piohelp@health.usf.edu



This office might also be interested in your thoughts:

University of South Florida College of Medicine
Office of Diversity Initiatives/Minority Affairs

12901 Bruce B. Downs Blvd.
MDC58
Tampa, FL 33612-4799

(813) 974-3609
FAX (813) 974-4990

Marvin Ted Williams, M.Ed., M.S.,Ph.D
Assoc. Vice President for Diversity & Equal Opportunity, USF
Assoc. Dean for Diversity Initiatives, USF Health

email: williamst@admin.usf.edu

Click here for the University of South Florida contact page


I don't know Dr. McKalip, I have never met the man.  But  I find it a little embarrassing to have gone to the same school as he did.

During the dark days of the Bush era, I was one of millions who looked to Obama as a hope for the future.  However, I remember when Obama voted for the telecom immunity bill.  Up to that point I had been regularly contributing to his campaign, but I never did again after that, and I wrote his campaign a letter about the issue.  However, I forgave him, and I even was fortunate enough to attend his inauguration.

Dune is one of the few books I have read multiple times.  To briefly summarize; Dune is a book about galactic political intrigue, and is set in the distant future.  The evil Baron Harkonnen plots to control the planet Arrakis.  He conquers the Atreides family and installs one of his two nephews as the ruler of the planet.  He chooses the brutal Rabban to take control of Arrakis and thus begins a reign of terror.  The Baron plans to wait until the inhabitants have suffered greatly to the point of breaking and he will then have Rabban executed and install Feyd to take over as Ruler.  He hopes Feyd will be welcomed as the Savior of Arrakis. However, Feyd is in fact even more sadistic than Rabban, just more refined.  He is a surgeon rather than a meat cutter.  In this situation, Paul Atreides finds himself struggling to survive after his family is defeated by the Harkonnens.  He is exiled to the desert where he gathers the natives and returns to defeat the Harkonnens and become the true savior of the planet Arrakis. Good defeats Evil.

Around the time of the telecom bill vote, I happened to catch Dune on television for the hundredth time.  I remember having a conversation about this with my family.  My mind made a connection between Bush and Obama with regard to the Rabban, Feyd, and Paul relationship.

As we know, Bush and his evil "Uncle" Cheney had spent quite an effort in establishing sweeping new authoritarian powers for the President.  These powers would not just disappear into thin air after the election.  The next US President would find him or herself in a new office with new powers over the US population that are unprecedented in our history.  This is a very tempting situation for anyone.  As the old saying goes, power corrupts.  My hope was that Barack Obama would reverse the Bush/Cheney unitary executive powers, but I also realized there was a great risk he would not when he voted for telecom immunity.

President Obama has made some disturbing choices regarding personal liberty and government secrecy.  Obama's Preventive Detention proposal goes beyond anything Bush ever publicly proposed.  We should all be nervous about the future.  Power corrupts, and absolute power corrupts absolutely.  I hope Mr. Obama changes course on these important issues.

I hope we elected a Paul and not a Feyd...

President Obama met with his Russian counterpart today to continue talks...

We interrupt this news for an important update:

King of Pop Michael Jackson is STILL DEAD!

Anyone old enough to remember when Elvis died will also remember the small industry that began shortly afterward.  You could buy Elvis Commemorative Plates.  Late night commercials sold compilation records and tapes of his greatest hits (only $19.99 plus shipping and handling, delivery in 6-8 weeks, NO COD).  Graceland opened and became a theme park/shrine/cemetery.  Elvis Inc. became big business.  The King of Dead Celebrities.

The King is dead, long live the King's Image.  And now we will see it all over again, but updated for the 21st century.  There will be a Michael Jackson channel on SIRIUS.  iTunes will have special deals on MJ MP3's.  Oprah will have entire shows dedicated to Michael Jackson's housekeeper.  There will be books!  And just wait until they open up Neverland Ranch to tourists (they already have rides!).  You will be able to walk through MJ's version of The Jungle Room.  For an extra five dollars you can tour the bedroom.

And people will pay!  We all love a good freak-show.  It will be a like driving by major car wreck on the freeway -- but frozen in time so the viewer can linger.  The post-respiratory phase of Michael Jackson's career has now begun.

Michael Jackson is still dead.

And in other news, Generalissimo Francisco Franco is still valiantly holding on in his fight to remain dead.

I am Steevo and you are not.

Who cares if a politician cheats on his wife?  I do not,  I actually sort of expect it.  Powerful men have powerful libidos.  Big deal.

The real Sanford story is that of a hypocrite -- a politician who voted to impeach President Bill Clinton for lying about a blowjob has now engaged in a weeklong exotic erotic bangfest with a married woman.  This same Governor actually turned down money to help the poor people of his relatively poor state, just to make a few political points with Rich White Assholes.

I would be happy if our politicians could at least be good politicians.  Instead, we now have perhaps the least effective congress in a long time.  Our country faces a dire situation, and one party has a rare lock on the executive and legislative branches, yet very little is happening.  We are still hemorrhaging money in Iraq.  Our healthcare system is going to collapse within five years.  Our entire economy nearly died six months ago, and is still on life support in the intensive care unit.  Unemployment is growing.  Stagflation will probably be next on the list.  And the military industrial complex has become the beast that Ike warned us about.  World War is still a real threat.  At least the US Government isn't as bad as the crazy California system.  Despite all this, I still hope Obama can make a difference.

Yet our "newsmedia" is run by adolescents.  CNN is a joke, Fox News is a criminal conspiracy, even NPR has been weakened.  Political reporting in the US is beyond pathetic.  The average US citizen is such a victim of propaganda, they no longer really have any sort of working knowledge of the world. 

Clinton, Spitzer, Edwards, Craig, Sanford, and that other recent guy whose name I can't even remember -- who cares who they fuck. 

Well, except Edwards, I still think he is a super douche...

One final thought, how bad would things be right now without Blogs like TPM???