Where have all the Doctors gone?

May 26, 2007 at 10:03 am (current events, issues, kvetching, misers, nursing, sticking my nose where it doesn't belong, whining)

“The accumulation of all powers, legislative, executive, and judiciary, in the same hands, whether of one, a few, or many, and whether hereditary, self appointed, or elective, may justly be pronounced the very definition of tyranny.” ~ James Madison, Federalist Paper 47.

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This post, by EM Physician (a blog I read frequently, and enjoy) made a few statements that got me thinking. But before we get started, someone made a comment I feel compelled to answer…

Not even going to touch the rest of your comment, ucalcal, but this?

Where are the nurses on ensuring enough paramedics are available to provide a quick response to 911 calls so sick individuals get to the hospital in time to be saved? (emphasis mine)

WTF? Like the nurses have control over the paramedic companies. You are talking out of your ass, man. Good grief.

That said, the reason nurses are catching so much flak here is because they ARE unionized. Squeaky wheel gets the grease, as they say. The bigger question is, why isn’t everyone else fighting, too? It isn’t the nurses’ fault that they are biased in favor of nurses. In Federalist Papers No. 51, James Madison said, “Ambition must be made to counteract ambition.” But where is the ambition of the docs, radtechs, etc?

If you want to blame someone, start by blaming yourself. Docs are seen as weak because they are weak. Pushed around for the last five decades by an increasing mound of paper, allowing the insurance corporations and government bureaucrats to dictate patient care. Then, someone (nurses) stands up and says, “Hey, we’re not going to take this anymore!” and you cry “foul”? You cast all the blame on the nurses?

That’s crap, and you know it. Get your fellow docs to wake up and DO something. It’s not good for one voice to dominate in any arena, but if no one else will speak up…I guess you’ll have to take what you get.

Oh, and about the quote? I think “tyranny” could justly describe the amount of low- and mid-level government interference in healthcare. We’ve got so much paper to dick with that patient care is prime for a raging blaze.

Look at Yellowstone National Forest. Ever heard of “controlled burn“? Started in 1972. Burning, when done frequently and responsibly, eliminates the underbrush, stimulates growth, removes deadwood, etc. All good things for a forest. When natural burning is eliminated, you get a strangled forest.

That’s the picture of the healthcare system today–massive, overgrown. I don’t even like that phrase: healthcare system. It’s not health care. It’s sick care, or pretending-to-be-sick-so-I-can-score care.

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So, what’s the answer? I don’t have one. But I do know where the blame lies: with all of us. With the nurses, for pushing our own interests without an eye for the effect on the system.

With doctors, for ignoring the problem and hoping it’ll just go away.

With other professionals (radtechs, pharmacists, paramedics, etc.) for acting like the problem doesn’t include them.

With specialists, for opting out WITHOUT speaking up to the administration and the government.

With administration, for introducing/implementing policies and procedures willy-nilly, refusing to listen to staff complaints, and passing the buck.

With the numerous “associations”, who take your money but don’t do jack.

With the government, for doing a poor job of governing anything, and printing paper instead, mandating changes without looking further than the next election cycle.

With insurance company CEOs/CFOs/majority stockholders, who screw everyone and spend summers in Montana with Chuck.

And, lastly, with the patients, who are the crux of it all. Without patients, the system doesn’t exist. They are, in a word, essential. Yet they are unorganized, lacking advocates, because they don’t know what they need…which is where doctors and nurses come in. Yet so far, only the nurses have made their voices heard.

So.

Where have all the doctors gone?

2 Comments

I *heart* cake

May 17, 2007 at 4:20 pm (cooking, grandmother moments, misers, recipes)

I made Teacake today. Scratch, just like my great-grandma taught me. It’s creamy and moist, with a light lemon and almond smell and little crunches of poppy seed. Beautiful. If I had my digital camera, I’d give you a pic but unfortunately, that was one of the many concessions I made in order to regain control of my life.

This is my great-grandmother’s recipe, that she got from her grandmother and so on. Hope you like it.

Teacake (Coffecake. Whatever.)

Preheat the oven to 450 K (that’s like 350 f, or 177 C). In a large bowl,

1 stick softened butter
1 c. sugar
6 oz. cream cheese
3 eggs

Mix these together in order. Beat until glossy smooth. Add

1 tsp. vanilla
the grated rind of one large lemon
the grated rind of one medium orange

Mix gently. In a separate bowl, combine

2 c. flour
1/4 tsp. salt (or as my grandmother would say, a “biggish pinch”)
1 tsp. baking soda
1 tsp. baking powder

and mix these together. Alternate adding the flour mixture and sour cream until gone. (This takes about a 5 oz bowl of sour cream. I like to add a little lemon juice to mine, as well as a few smacks of poppy seed. Spoon this into a buttered bunt or tube pan. The dough will look really thick, and like there isn’t much there. Don’t worry, it’ll rise like anything and give you a moist, fluffy cake. Cook it until it’s done, a little over half an hour.

For the icing, mix together three-quarters of a stick of softened butter (4 oz sticks, okay?), 1.5 c. powdered sugar, 2 tablespoons heavy cream, 1 teaspoon almond extract, the rest of the rind from that orange, and the juice of a couple lemons. Or an orange, or a couple limes. Whatever.

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My great-grandmother taught me to measure ingredients according to taste, feel, and weight. I know what half a teaspoon of sugar, salt, soda, whatever looks like in the palm of my hand. I taste everything until it tastes “right”. I cook with “double-handfuls” of beans instead of cups, and somehow it always comes out right.

She taught me little tricks, like softening the veggies with salt before cooking will allow them to hide in the background…adding a bit of fresh herbs and parsley at the end of cooking will make the flavors bright…anything chicken will take a citrus punch and run with it…and pot pie is stew-in-a-pastry. I learned how to make homemade biscuits, to bake my own bread, and how to use masa flour and molasses to make sweet cornbread pancakes for breakfast. Giblet gravy with slices of eggs. I wouldn’t have known the ache of kneading, the solid weight of a ceramic bowl, the burn of rapid whisking during hollandaise-induced hypnosis. The pleasures and pains of caring properly for cast-iron–how strong and smooth the pans can be–the tension of arms and wrists when removing from the oven, the warmth that lingers, keeping roast beef ready whilst making the gravy and mashing potatoes.

I wish I had been there when they sold her house, her belongings. I got her wedding china, her tea-set, per her wishes. But the canning equipment and vase-style jars were sold, and the whole of her cast iron went for $30–money I would have gladly paid, and many times that, to keep those receptacles of memory to myself. Her canning jars weren’t the common brand, Mason, that so many American southerners know–these were like vases, fluted, with soaring necks. Elegant in their rows, glass-capped and gleaming. The pressure-cooker, the stacks of red towels and it’s sister-stack of white…Enough to fill a large pantry, gone for $25. The white linen tablecloth and napkins–gone as well, along with the white lace overslip she used for special occasions, funerals.

It was mother’s day this week. Somehow it passed me by–I got a card from the kids, breakfast by DH. I took my mother a Starbuck’s Tuxedo. It was cold by the time I got there, but hey, it’s the thought that counts.

My grandmother is still alive, and I love her dearly. It wasn’t her doing, the sale of the estate. That was her brothers’ doing, and if she knew about some of the stuff she’d…I don’t know what she’d do, but I’m sure blood would be involved, and it wouldn’t be pretty. Her brothers, my granduncles, care more about dollars than they do memories. They had plenty of money–they simply weren’t interested in keeping around all that dead weight.

If I could think of some appropriate profanity, I’d use it. Some things are too heavy for words.

4 Comments