When does life end, and begin?

I had this very good friend in college named Lynn, who I started thinking about recently after I read two disturbing news stories. We met in the autumn of 1975, and within a year of that, she and I had made a pact that if either of us were seriously injured or ill to the point where the quality of life was gone, then the other would pull the plug, literally, if necessary. This was at a time before living wills and health care proxies and the like were common.

I was reading this terrible story about 13-year-old Jahi McMath in Oakland, CA, who has been brain dead since December 12, “three days after she underwent a tonsillectomy and adenoidectomy.” She’s been moved to a facility in New York.

As the article notes:

While laymen tend to use the words “coma” and “brain dead” interchangeably, in medicine they mean very different things.

“Coma” is the broader term used to describe a prolonged state of unconsciousness

The flu shot: new venue

I thought, before I had it 7 or 8 years ago, that the flu was like a very bad cold. I was very wrong. The flu made me feel miserable. I mean missing a full week from work miserable.

Since then, I’ve been religiously getting my flu shot every year, usually when I get my annual physical in early autumn. In the past year, though, the practice of my primary care physician (PCP) has been taken over by one of the large hospitals in the area. As a result, my PCP doesn’t know when the flu vaccine would reach the office. I was encouraged to get my shot at Wal-Mart or ShopRite or wherever I could.

For some reason, I found this oddly unsettling. I’m sure that the acquisitions of the offices of my PCP and similar locations involve the hospital wanting to have the right mix of facilities under the Affordable Care Act, a/k/a Obamacare. Presumably, the economies of scale are supposed to make things more efficient, but that wasn’t the case in this situation.

At my local CVS, there were signs encouraging people top get flu shots there, so I inquired. My shot would be covered fully by my insurance, so I for the shot from the pharmacist behind this partition. My wife can go there too, but my daughter cannot because she is under 18.

Getting the shot at the pharmacy rather than the doctor’s office is different, but no less convenient. The new way of doing things, in this case, was not so bad after all.
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H is for Health insurance and History (mine)

When I moved from Schenectady to Albany in 1979, it was, in large part, to go to graduate school at the University at Albany (which may have been called SUNY Albany at the time – I forget) in the School of Public Administration.

A few days before the semester began, I went to a very nice party outdoors at a friend’s house, where I was walking in the grass with bare feet. A few days later, one of my toes on my left foot started to hurt, at first just a bit

An American doctor's life

I’m very fond of my general practitioner. I’ve been seeing her for only about a decade, though it seems longer. Inevitably, when I have a visit, especially my physical, we talk. Actually, she talks more than I do.

One of the things she’s had to get used to is the conversion of a bunch of medical records from paper form to electronic form. This happened on her own dime a few years back, when she had to acquire the expensive – and not always reliable – software, and hire med students to input the info. Ideally, this meant that all of my current medications would then pop up on the screen, but no

Amy wants me to write about health care

Amy of Sharp Little Pencil, who, like me, grew up in Broome County, NY, writes:

So Roger, do a piece on health care if you haven’t already, please. My post cited numerous reasons why Americans DON’T want it (as George Harrison would sing, “I, Me, Mine,” also the fear struck in their hearts. Could not believe how many FOX talking points turned up on my blog!! Let me hear about it soon! Love your blog and you, Rog. Peace, Amy

Here’s the problem, Amy. I don’t know how to speak of it in any better terms than others have. The fact that catastrophic illness and injury has contributed to most personal bankruptcies. The fact that preventative care will lower costs over time and provide a healthier population to boot. The fact that a larger pool of consumers, historically, has lowered the costs of goods and services. But these anyone can tout.

For me, though, it’s always been about that same Harrison song you quote.

Blood, music, SCOTUS

I’ve now donated blood 149 times. The only two times I’ve ever had difficulty were time #59, obviously several years ago, and time #148, in April 2012. The commonality was that I was sitting in a chair each time, rather than lying down. The April visit was brutal, with three different attendants manipulating my arm, the needle…it took well over 20 minutes, when it generally takes me 6 or 7; I’m talking about the actual blood flow time, not the preliminary exam, et al. I was so exhausted and bruised afterwards, that I went home and went to bed, instead of going to choir, which had been my intent.

So when I went again last week – getting “back on the horse,” as it were – I made sure I went to a place (Empire State Plaza, for you locals) that had cots.

Why Health Care Costs So Much in America

A worker in a health care provider’s office told me this story. It explains a lot.

A medical provider rendered services to a patient in 2008, and subsequently submitted a claim to the insurance company, which paid it.
In 2010, the insurance company decided to not pay for the service because the patient had other insurance coverage.
The provider had to go prove to the insurance company that the patient had no other coverage.
The provider resubmitted the claim to the insurance company.
The insurance company rejected the claim because it was not submitted in a timely manner!
The provider noted to the insurance company that it had PAID the claim two years earlier, then rejected the claim in error.
The insurance company finally paid – again.

I know this story is true because another provider is dealing with an insurance company that is claiming my wife has additional coverage, something she did actually have, but cancelled three years ago.
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Take Out Some Insurance On Me, Baby (Uncensored) – The Beatles featuring Tony Sheridan.

World Pneumonia Day – November 12, 2011

I knew instinctively that childhood pneumonia deaths, once too common, are now very rare in the US. I’ve been told that they have decreased almost 99% since 1939, thanks the discovery and availability of effective medications. But children from developing countries aren’t so lucky. Each year 1.4 million children under 5 die from pneumonia – more than any other cause. More than from AIDS, malaria and measles combined!

Half Way In

It’s halfway through Barack Obama’s first term as President, and I’m filled with a lot of mixed feelings. On one hand, I think his rhetoric far outstrips his ability to govern. In other words, he promised much more than he could deliver. On the other hand, if Bill Clinton was hampered by a “vast right-wing conspiracy,” that was nothing compared with what Obama has been faced with.

What initially struck me about the President-elect back in December 2008 is that he was already acting as though he were already in charge. The bad news about the economy was becoming more fully released, and he appeared fully involved in trying to fix it. My wife noted at the time that he seemed more visible than the 43rd President.

So his inaugural speech was less inspirational than I might have wanted; still we were promised the audacity of hope. Thus, it seems that a lot of people saw Barack Obama the way they WANTED to see him. Surely, he’ll get rid of the onerous secret human right violations that many were distressed about under his predecessor. That did not prove to be the case.

The American participation in the war in Iraq had greatly diminished, as he said would happen, but he was never allowed any credit for that in some circles because he had opposed the war in the first place, and moreover opposed the surge that most analysts suggested allowed for the withdrawal.

Meanwhile, the war in Afghanistan has expanded, with the end point pushed back later (2011) and later (2014).

In his dealings over health care, it seemed that