This past week I went with my daughter to visit a college campus that she is interested in applying to. She is a senior in high school and is going through he process of college selection. I think the competition to get into the top universities is much more intense than when I applied almost 30 years ago. I do not envy her as she goes through this process. If you look at the numbers, there are so many kids with perfect SAT scores, top grades and excellent extra-curriculars it seems a very daunting task to go through this process. So many kids go through intense tutoring and spending their summers in educational pursuits that the bar has been risen to unobtainable heights. These kids are prepped to the exclusion of having a "normal" teenage lives just to be able to get into a particular college. Many of these kids lack adequate and critical social skills which are so important in almost all professions and businesses.
I keep telling her that it is not the most important thing where she goes to school and that she will be happy wherever she attends. I encourage her not to fall in love with a particular school that she can attain her goals regardless of the school she attends. I tell her that ultimately it is the qualities that she possesses, not the university from which she graduates that will dictate her success. Nevertheless, her desire to excel generates pressure on herself to go to a top school and I fear her disappointment if this doesn't occur.
After listening to the admissions officer discuss what the school looks for when making their selections, I think that they get it. They do not only look at the numbers but at the entire package. I don't know how they do it and I think it is a very difficult task to weed through thousands of applications and make intelligent selections. Somehow they are able to determine from an application who is the best fit for their university. They understand that the goal is a well rounded child who can excel in their schoolwork yet can also be a good communicator, a leader not just a human computer with perfect numbers.
Say what you want about the average high school graduate in this country, but the upper echelon of graduates that are generated are extraordinary. There always seem to be a group of kids that excel and will be able to successfully compete with piers from anywhere in the world. This is created by their own innate ambition and their desire to excel, not by an external force. I very much hope my daughter gets into the college of her choice but I have no doubt she and other graduates ultimately achieve based on their own assets and liabilities not by the words on their diplomas.
Saturday, September 26, 2009
Sunday, September 20, 2009
Race Relations under BO
This week I was on call and was called into the hospital in the middle of the night to consult on a patient who was having an emergent problem breathing. He bit his tongue and the entire tongue swelled to the point where it was blocking his ability to breath. When I arrived at the bedside in the intensive care unit there was a Filipino nurse an Indian hospitalist, an Arabic respiratory therapist, an African American anesthesiologist and me, a white Jewish guy. This is truly a remarkable collection of disparate ethnicities that were brought together that night. Almost every corner of the globe was represented that night, assembled to save the life of this man. The truth is nobody in that room cared about the sex, color, religion, or age of the other people. Especially the patient didn't care, he just wanted us to do our best to help him.
When I arrived there I saw the anesthesiologist who was trying to help this man. I have known him for several years and is one of the best anesthesiologists I have ever worked with. I was incredibly relieved knowing that he, in particular, was there as we worked together to save this man. His skin color never was or is a factor in our working relationship. We respect each others ability to do our jobs as we aim to help our patients. We look at each other and we look past the superficial. When I look at him I do not see a black anesthesiologist, I see an extremely competent professional, an excellent anesthesiologist. This patient was very lucky to have had this anesthesiologist on call that night. The two of us live in a post-racial world where we judge each other not by color but by our abilities.
This episode stands in contrast to what I am reading in the newspaper and seeing on the television. The comments by Jimmy Carter that opposition to BO's health care is racially motivated. The questions of Barbara Boxer to Harry Alford about his taking a position not in line with the black caucus. The recent discovery that BO's czar Van Jones believed white people were intentionally polluting black communities. All these are making race relations worse. BO was supposed to be healing racial tensions but I believe instead things are getting worse. Certain people in both parties cannot get past the color thing. One might expect more from the dems as they are the party that supposedly represents most African Americans. But every time they bring up the race card they show they are just as fixated by color and cannot see past peoples skin.
We will never live in a post racial world as long as every time someone opposes a position by BO they are called racists. How are we supposed to have a democratic system if your motives are questioned whenever you disagree with a position held by someone of the opposite sex, different color, or another religion. Fortunately for that patient the other night, many of us do live in a post racial world and see each other as colleagues and partners. We work together as equals to perform for our patients. We see past the amount of melanin in our skin. We in the real world have made great progress in this regard while the government and politicians cannot and may in fact be contributing to undermining this progress.
We all thought that having an African American president would be great for the country. Even if we didn't believe in his policies it would demonstrate that we are past the whole race thing that we could elect a black president. Unfortunately, I believe the legacy will be that race relations will worsen under his administration. There are just too many people white AND black that just cannot see past skin color.
When I arrived there I saw the anesthesiologist who was trying to help this man. I have known him for several years and is one of the best anesthesiologists I have ever worked with. I was incredibly relieved knowing that he, in particular, was there as we worked together to save this man. His skin color never was or is a factor in our working relationship. We respect each others ability to do our jobs as we aim to help our patients. We look at each other and we look past the superficial. When I look at him I do not see a black anesthesiologist, I see an extremely competent professional, an excellent anesthesiologist. This patient was very lucky to have had this anesthesiologist on call that night. The two of us live in a post-racial world where we judge each other not by color but by our abilities.
This episode stands in contrast to what I am reading in the newspaper and seeing on the television. The comments by Jimmy Carter that opposition to BO's health care is racially motivated. The questions of Barbara Boxer to Harry Alford about his taking a position not in line with the black caucus. The recent discovery that BO's czar Van Jones believed white people were intentionally polluting black communities. All these are making race relations worse. BO was supposed to be healing racial tensions but I believe instead things are getting worse. Certain people in both parties cannot get past the color thing. One might expect more from the dems as they are the party that supposedly represents most African Americans. But every time they bring up the race card they show they are just as fixated by color and cannot see past peoples skin.
We will never live in a post racial world as long as every time someone opposes a position by BO they are called racists. How are we supposed to have a democratic system if your motives are questioned whenever you disagree with a position held by someone of the opposite sex, different color, or another religion. Fortunately for that patient the other night, many of us do live in a post racial world and see each other as colleagues and partners. We work together as equals to perform for our patients. We see past the amount of melanin in our skin. We in the real world have made great progress in this regard while the government and politicians cannot and may in fact be contributing to undermining this progress.
We all thought that having an African American president would be great for the country. Even if we didn't believe in his policies it would demonstrate that we are past the whole race thing that we could elect a black president. Unfortunately, I believe the legacy will be that race relations will worsen under his administration. There are just too many people white AND black that just cannot see past skin color.
Saturday, September 12, 2009
Perspective
As much as I rant about the issues related to health care I must say that the practice of medicine is a very sobering one. This past week I had the unfortunate opportunity to diagnose two women in their twenties with cancer. They both came with masses in their necks and after biopsy were both positive for lymphoma. They were living completely normal lives until one day they felt something abnormal in their bodies. It is unimaginable that in the course of days we can go from our normal routine to our lives being turned completely upside down with our lives in jeopardy. I am left with something very important and that is perspective as my "problems" seem very small after having to tell these women their diagnoses.
I think we tend to lose our perspective as we focus on the details of our lives. This is likely our natural tendencies to concentrate on our own sheltered lives until we are exposed to another's tragedy or perhaps one of our own which then give us perspective. It is unfortunate that it takes a shock to regain our sense of what is truly important. On the other hand, is it preferable to go through life with the attitude that things can always be worse, that every problem that arises is negligible compared to what these women are faced with. This approach tends to minimize any conflict that is not tragic which can also be problematic.
Clearly, the balance lies somewhere in between where we deal with our problems but always keep them in perspective. This is easy to say but difficult to live. We tend to drift back into our own worlds as it is too difficult and painful to live our lives thinking that tomorrow or the next day we will feel a lump somewhere in our bodies that shouldn't be there. I think as doctors we are faced with people's tragedies and are reminded often about perspective which tends to minimize other problems that may arise. This doesn't necessarily work well if our spouses do not share our perspective and feel that we too easily dismiss what they consider problematic. I suppose this is an occupational hazard.
These next few weeks are the period in the Jewish calendar where we are judged and our fates are determined for the coming year. Who will live and who will die. Whether one believes that his/her future is determined in the next couple of weeks is a personal issue but it certainly demands that one put their life into perspective. We never know whether we will wake up one day with a lump somewhere and our lives will forever be turned upside down.
I think we tend to lose our perspective as we focus on the details of our lives. This is likely our natural tendencies to concentrate on our own sheltered lives until we are exposed to another's tragedy or perhaps one of our own which then give us perspective. It is unfortunate that it takes a shock to regain our sense of what is truly important. On the other hand, is it preferable to go through life with the attitude that things can always be worse, that every problem that arises is negligible compared to what these women are faced with. This approach tends to minimize any conflict that is not tragic which can also be problematic.
Clearly, the balance lies somewhere in between where we deal with our problems but always keep them in perspective. This is easy to say but difficult to live. We tend to drift back into our own worlds as it is too difficult and painful to live our lives thinking that tomorrow or the next day we will feel a lump somewhere in our bodies that shouldn't be there. I think as doctors we are faced with people's tragedies and are reminded often about perspective which tends to minimize other problems that may arise. This doesn't necessarily work well if our spouses do not share our perspective and feel that we too easily dismiss what they consider problematic. I suppose this is an occupational hazard.
These next few weeks are the period in the Jewish calendar where we are judged and our fates are determined for the coming year. Who will live and who will die. Whether one believes that his/her future is determined in the next couple of weeks is a personal issue but it certainly demands that one put their life into perspective. We never know whether we will wake up one day with a lump somewhere and our lives will forever be turned upside down.
Sunday, September 6, 2009
Something for Nothing
This week a 47 year old female came to see me in the office. She weighs 275 pounds and she came to see me for a minor problem. I looked at her insurance information and was surprised to see she had medicare. For those of you who don't know medicare is not only for the elderly but it also is given to people who qualify for permanent disability. Aside from her weight she did not appear to be someone who is completely disabled so I asked her the nature of her disability. She explained she tore something in her knee which was repaired and thus she was placed on permanent disability. As a result she receives medicare and disability payments from the government forever. She then proceeded to leave the office walking without difficulty.
There is no reason why this lady should qualify for disability especially because her knee problem was likely caused by her own self inflicted obesity. There is no doubt in my mind this woman is completely capable of some type of employment but it is much better for her to collect disability than to get a job. I wouldn't even be surprised if she does have a job that pays her under the table and thus does not get reported and effect her eligibility for disability. Basically she is gaming the system at the expense of the taxpayer.
This is what tends to happen when government takes control and offers free services. What I call the something for nothing crowd finds ways of gaming the system to get freebies and benefits that they are not truly entitled to. So even though the government may be well intentioned in trying to assist the poor and disabled when people see the government giving out money, they line up. The government does not do a good job at policing who gets the benefits and is truly qualified or if they are just cheating. They just keep doling out freebies and continue doing what they are good at which is taxing and borrowing. It is government's duty that if they are going to confiscate my money and my kids and grandchildren's future earnings through taxation and borrowing to give to someone else they better be darn sure that person is truly deserving of it.
In general, the government is not good at policing fraud and abuse in their welfare programs and this is seen in the medicare program where estimates are as high as 10%. It is not surprising since government believes it has no limit on its spending and little incentive to cut the fraud. They'll just keep sucking the blood from the taxpayer. The truth is, the present government probably couldn't care less whether there is fraud because ultimately there goal is to redistribute wealth from the taxpayer to the non taxpayer. Whether this is done honestly or through fraud doesn't matter as long as the ultimate goal is achieved.
There is a segment of the population in this country who try to live off the benevolent nature of the government. They justify in their minds that they are somehow entitled to these benefits and do not see themselves as cheaters, thieves, and parasites. They don't see that they are in effect taking money from someone else unfairly because government is in the middle taking the money through taxes and then giving it to them. I do not know if this exists in other countries but my feeling is this is much more prevalent in this country. As government expands expect the something for nothing crowd to be lining up.
There is no reason why this lady should qualify for disability especially because her knee problem was likely caused by her own self inflicted obesity. There is no doubt in my mind this woman is completely capable of some type of employment but it is much better for her to collect disability than to get a job. I wouldn't even be surprised if she does have a job that pays her under the table and thus does not get reported and effect her eligibility for disability. Basically she is gaming the system at the expense of the taxpayer.
This is what tends to happen when government takes control and offers free services. What I call the something for nothing crowd finds ways of gaming the system to get freebies and benefits that they are not truly entitled to. So even though the government may be well intentioned in trying to assist the poor and disabled when people see the government giving out money, they line up. The government does not do a good job at policing who gets the benefits and is truly qualified or if they are just cheating. They just keep doling out freebies and continue doing what they are good at which is taxing and borrowing. It is government's duty that if they are going to confiscate my money and my kids and grandchildren's future earnings through taxation and borrowing to give to someone else they better be darn sure that person is truly deserving of it.
In general, the government is not good at policing fraud and abuse in their welfare programs and this is seen in the medicare program where estimates are as high as 10%. It is not surprising since government believes it has no limit on its spending and little incentive to cut the fraud. They'll just keep sucking the blood from the taxpayer. The truth is, the present government probably couldn't care less whether there is fraud because ultimately there goal is to redistribute wealth from the taxpayer to the non taxpayer. Whether this is done honestly or through fraud doesn't matter as long as the ultimate goal is achieved.
There is a segment of the population in this country who try to live off the benevolent nature of the government. They justify in their minds that they are somehow entitled to these benefits and do not see themselves as cheaters, thieves, and parasites. They don't see that they are in effect taking money from someone else unfairly because government is in the middle taking the money through taxes and then giving it to them. I do not know if this exists in other countries but my feeling is this is much more prevalent in this country. As government expands expect the something for nothing crowd to be lining up.
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