Personal Narrative

There ought to be…

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Family member A is ill — cold? flu? Gets worse. Calls doctor.

Doctor is away. A speaks with doctor’s colleague. Colleague listens to A’s account of symptoms, tells A to go to emergency room.

Family member B accompanies A to hospital. Emergency-room doctor examines A — infection? what’s that thing in lungs? Doctor asks if recent chest x-ray is available. B and C (me) consult by phone. B tells emergency-room guy to call A’s doctor’s office to access whatever records are there. Meanwhile I track down most-recent CT-scan records at another hospital. B is now driving there to pick up a disk with the scans on it.

In the middle of our discussions B says something like: This is crazy. All of these records should be centrally accessible and under the control of the patient. Why isn’t all of the information we need available online?

B is right. In the current system service providers control most of the information but have little incentive to coordinate access with other service providers. Indeed there is a disincentive to do so: they can get into trouble if information is misused but don’t benefit directly when improved information-sharing helps patients.

Technically, this is not a difficult problem. Institutionally and legally, however, it seems to have much in common with drug-resistant bacteria.

At least there is progress in other areas. The practice of medicine itself seems to improve over time. And thank God for cellphones, and for the technology that makes it possible to put a copy of a CT scan onto a computer disk in a few minutes.

Making the Best of a Bad Situation

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This is a nice story. An American airman is shot down in 1943 over a remote Pacific island. The natives rescue him, hide him from the Japanese and nurse him back to health. He eventually returns home, marries and starts a family and career. Years later he returns to the island and renews his relationship with the natives. Back in the USA, he sets up a charity to help them. Over the course of many years he helps the natives to build a school, library, clinic, etc. The natives’ lives improve, and he gains a sense of purpose and accomplishment, to such an extent that he is grateful for the misfortune that initially brought him to the island.

New Orleans Bleg

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When my wife and I were planning our wedding 13 years ago we reached the point where it started to get hairy.   You know what I mean…where is so and so going to sit, what color will the linens be, who will do the toast at the reception, etc, etc, etc.

 I will give you the very short version of the ending – the planning process started to involve way too many people and quickly spiraled out of control.   I remember to this day sitting on the couch in our apartment (yes, we lived in sin!) and saying to my fiance at the time, still my wife to this day the following:

Do you want to get the heck out of here and elope to New Orleans?

 The answer was an enthusiastic YES.

And so we did.   That was back in 1995.

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“Getting to Know Your Shrapnel”

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A woman in Israel who was injured in a terror bombing in 2002 blogs her observations (via SondraK, via Steve):

Unless the shrapnel is causing damage, doctors will leave it where it is. Unfortunately there appear to be some differences between “causing damage” as defined by doctors and “causing damage” as defined by the average layman. For instance, many doctors do not define shrapnel which makes one’s face numb in parts and lumpy to the touch as “causing damage”. One doctor concluded his examination of my face with a cheerful “Zeh lo catastrof”, this isn’t a catastrophe. On the bright side, I am using this experience to force myself to pick up that essential, Israeli trait: the ability to argue with ANYBODY, including one’s doctor, even if the doctor is a neurosurgeon who might be called upon later to do very delicate surgery on one’s face. In the meantime, however, my shrapnel has been classed as “mostly harmless”, a good chunk of it is still in me and I should be setting off metal detectors for years to come. Theoretically, the average terrorist should have an easier time getting into the Central Bus Station than I will (more on that later).