Read and Weep

In Britain, an 83-year-old woman has been told that she must find a new medical practice, because travel to the one she has been attending for the last 30 years involves an unacceptable carbon footprint.

Dick Boggs

When I was a medical school junior, we had a rotation on the Neurology service at LA County Hospital. One of my classmates was planning a career in neurology but the reason it was so popular with the students like me who were interested in surgery was that we got to do tracheostomies. A number of patients with severe neurological lesions would require respirators or had trouble with airway secretions requiring a tracheostomy. This was our one chance to do surgery, even a minor procedure as things go. It was good practice and I later did a lot of tracheostomies, some quite difficult and rushed.

Our resident was a very interesting guy named Dick Boggs. He was tall and looked a lot like Orson Welles did when he was young and making “The Third Man.” Boggs was quiet and aloof but let us do trachs and work up any patient we wanted to. I had some very interesting cases. One was a woman who showed all the signs of alcoholic neuropathy, which is very similar to diabetic neuropathey. It was a popular rotation for juniors. Boggs was popular among the residents and was elected the president of the Interns’ and Residents’ Association, which under his leadership took on some of the characteristics of a union.

At the time, intern and resident pay was very low and, aside from a new dormitory that was built for single house staff, we were on our own. I was married with one child, born in March 1965, so I was really on my own. My wife quit her job as a teacher in January 1965 and I was working after hours doing histories and physicals at private hospitals for $7 per hour. Fortunately, my tuition was covered by scholarship but living expenses were tight. We lived on $200/month contributed by our parents, $100 from my father and the same from Irene’s parents. Half of that went for the rent of our two bedroom house in Eagle Rock, near Pasadena. I’m spending some time on details to emphasize what Boggs accomplished for us all.

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Nationwide Rally for Religious Freedom: Friday, March 23, Noon

Stand Up For Religious Freedom

The Nationwide Rally for Religious Freedom is being held Friday, March 23 at noon, local time, outside federal buildings, Congressional offices and historic sites across the country. The theme for the Rally is “Stand Up for Religious Freedom—Stop the HHS Mandate!”

Nationwide Rally Locations and Info

Chicago: Federal Plaza, 50 W.Adams, Friday, March 23, Noon.

Click on the link to find a location near you.

Quote of the Day, Cardinal George on the HHS Mandate

If you haven’t already purchased the Archdiocesan Directory for 2012, I would suggest you get one as a souvenir. On page L-3, there is a complete list of Catholic hospitals and health care institutions in Cook and Lake counties. Each entry represents much sacrifice on the part of medical personnel, administrators and religious sponsors. Each name signifies the love of Christ to people of all classes and races and religions. Two Lents from now, unless something changes, that page will be blank.

Francis Cardinal George, Archbishop of Chicago, on the HHS Mandate.

RTWT. The column from the Cardinal is very good, though too fatalistic.

This vicious thing can be stopped and rolled back.

Iatrogeny in Management Reporting

In medicine, an iatrogenic disease is one that is brought on by a medical treatment itself. An example would be when a physician treating a minor condition fails to properly wash his hands and as a result gives the patient an infection more serious than the original problem.

It strikes me that iatrogeny also occurs in the management reporting and control systems of businesses and other types of organizations. A particularly awful example was reported in Britain a couple of years ago: hospitals were being measured on time from a patient’s entry into the emergency room until the time that patient was seen by a physician. It appears that in quite a few cases, the optimization of that measurement for the hospital was achieved by leaving the patient in the ambulance, in some cases for as much as five hours, so that the clock on the measurement would not start until the criterion was certain to be achieved.

So a measurement intended to improve patient service had the opposite effect. It directly caused unnecessary pain and danger to the individual ER patient who was kept in the ambulance while harming the effective utilization of expensive vehicles and skilled personnel, while at the same time providing upper management with a distorted picture of what was really going on.

Smirk not, fellow capitalists. While this particular example of iatrogeny was perpetrated by a government entity, plenty of examples can also be found in the private sector. Indeed, I saw an interesting example in a Target store just the other day.

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