June 10th, 2005


Hats off to Women's Softball

Dialysis clinic rounds and Thai restaurant visits suffered this week as self-indulgence took over, and I settled in to watch the Lady Bruins cut through the softball world series like a knife through warm butter. Not quite that easily, but they seemed to be on a mission and they peaked at exactly the right time. When ESPN devoted their programming to womens softball, I put non-emergent visits on hold and made it a point to watch the TV every time the Lady Bruins played. I neglected to wear my Bruin tie on game days, a critical but unrecognized fact, that contributed to the 1995 Bruin Basketball Championship. Perhaps, that's why the butter turned to granite, Michigan granite, and a determined bunch of Wolverines who were ranked number one, and showed us why with comeback victories in the final two games, after losing the first while playing the second game of their doubleheader. This followed an extra innings victory over Tennessee. It was a very exciting series, and coming on three consecutive nights, there was a feeling of getting to know the players and the coaches from both teams.

There are different techniques in softball and I am still learning some of the specific jargon but the game unfolds so much quicker than baseball, the distance between bases and the pitcher's mound to the plate are so much shorter, that the action seems to be more frequent and more exciting.

The Lady Bruins finished fifth in their league, won the critical game in five elimination contests, and found themselves playing for the championship as the 7th ranked team in the tournament, and yet they went into the final round of the world series, undefeated. Michigan, the first ranked team, entered the three game championship series with one loss, and they had to win their last game to make it to the final round. The game was played in the morning and they had to come back that evening to play the Bruins for the first time. The Bruins prevailed on a day's rest. Not exactly a fair match. But, that was it. The Sluggers were brutal. Samantha Findlay tied the game in the 6th inning and put it away in the 10th with a 3 run homer. Both teams had opportunities to win it earlier, but the Wolverines Jenny Ritter retired the crucial batters after an opening double, and with the bases loaded. On the Bruin side, with Wolverines loading the bases, Angela Duran grabbed a hard hit liner at third base and doubled the runner, and Angela Seldon struck out the batter to end the inning. The opportunities were there for both teams, but the Wolverines cashed in.

It was a great series, and a first victory for a team from east of the Mississippi River. It should be noted that California fuels the dreams of many softball programs and some of our local girls played for the Wolverines. Hats off to the ladies, and to Samantha Findlay, freshman with a Ted Williams swing. Great effort Lady Bruins, from fifth in conference to runner up. I'm looking forward to next year.
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    Hail to Victors Valiant!

Easy Money!

My time is worth $600 an hour to market research folks, and to Big Pharma who pays them. I just did a half hour interview, which took 45 minutes, and paid me $300, to give the researchers my view of a product about to be released to change the convenience of taking transplant rejection drugs once a day instead of every 12 hours. Yes, it would help compliance. But patients who have been on dialysis and have a second chance at a more normal life after a transplant, are pretty compliant about taking their medicines, at least in my practice. The marketing tool is to convince physicians that the new copyrighted product is going to do everything the old copyrighted product did, at the same price, with the convenience of once a day therapy. So far, so good.

At the end of the interview, it became apparent that the current product loses its copyright, and will be competing with a cheaper, and presumably, equally effective, generic version. How interesting that the patent holder comes up with the new product at about the time the generic competition arrives at a cheaper price.

This is a very familiar story in the area of pharmaceuticals, the most profitable area of health care, and that is why my 45 minutes was worth $300, and taking care of undocumented patients without insurance, saving lives, is worth, to the state, practically nothing. So, I am volunteering myself as a very good interview to Big Pharma, and, yes, I'll take my cut in the good old American free enterprise way, but
don't expect me to use the product unless it does a different job, more effectively, than the least expensive, equivalent generic product. At least not until we have universal health insurance.

I feel lots better, thank you.
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    any thing Woody Guthrie wrote

Myles on the go! Will they ever sleep!

When your son sends you pictures at 3 AM, he is being a very proud father, and responding to the call of paternal responsibility.... his, not mine. We will be visiting Tammy and Josh tomorrow, and seeing Little Geoff and Kaci, children of my oldest son, John and Sheryl, just before that, and after a pretty easy day of 3 patients in 3 hospitals to round on, and maybe a dialysis clinic or two. These pictures were to keep us going until we get to see Myles, who will be one week old in about 3 1/2 hours.... but who's counting.

The captions are largely unmodified from those sent to a very good friend a few minutes ago who has somehow been vaccinated against blogging. She has her reasons, but she did get to see this first, because she is special, and I'm announcing that should she choose to visit the site.

So, starting with the pictures, all taken by either Josh or Tammy, Josh writes, “Sleep deprived and loving every minute of it… It’s great to be a father. Here are some more pictures to help hold you over until Saturday.”

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Charles Atlas pose from Myles. I wouldn’t threaten “Buster” as he has enrolled in a nursery based body building course, and demands on time feedings. Tammy is breast feeding and he seems to be thriving, the old fashioned way.

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I believe she just finished saying, “I think we’ll keep him!” He is so wanted, and they are so sane! The blotches are gone and he’s a happy fella. I believe he gets handsomer every day! Unbiased, of course.

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“Look, Ma. After less than a week, I’m self-supporting!” The tyke shows a tendency toward independence at an early age. Nevertheless, he has already applied for a Blue State birth certificate, and will be a card carrying Democrat!

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Well, I just love this. And I love Boeing, and paternal leave, and bringing fathers back into child rearing, and I’m damned sorry that the lure of saving lives distracted me from the closeness that I wish I would have had to a far greater extent with my children. Never, for a moment did I realize that in becoming a physician, at least as I envisioned how a physician should be, I was choosing to place my family, my wife and my children in a secondary role, for the benefit of a higher calling. And that’s why, when daughter Becky says, “Saving lives is highly overrated,” half joking of course, it isn’t a joke. It’s a choice! And it’s a choice that I didn’t consciously make. Not to make so much of it, because soldiers, firemen and many others face the same kind of situation. I am certainly not jealous of my son, but I’m very proud of the choice that he has made, and the constant battle of families who need 2 incomes to survive, or think they do, and constantly battle this situation.... A career or parenthood, or both.

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So, I’m in love.... Again. And I can’t get enough of him, of them, of sunflowers, spitfires, Porsches, friends, travel, different cultures, blogging, philosophy, Elderhostel, and of course, my wonderful wife.

I missed a meeting yesterday in Corona that I wanted to go to. My friend, Imam Ali Siddiqui was on a panel put together by the Interfaith Council, and I wanted to surprise him by showing up, but I had the good sense not to let him know I was coming because I have office hours until 5 PM, and rush hour traffic from Orange to Corona is about an hour and a half, I figure. Well, the unexpected happened and I had to fight to get data, lab results, on a transplant patient because HIPPA, the privacy guarantee that is a good idea in theory, has the medical community scared to death. So scared to death, that even when the patient himself says to the doctor and the lab, via phone, "I want the data sent to the doctor whose office I am standing in!" Nope, not enough. Had to problem solve and it was pretty simple. A written release, faxed to the lab, when the ordering doctor's office refuse to forward the data they had to me, the doctor they had referred the patient to. Complicated! Anyway, I intimidated one lab person into sending me the data, but it took a half an hour, and a few grams of catechol amines (epinehprine) internally generated from the depths of self-righteousness. I just said that Quest Diagnostics and Uni-lab would never see another patient of mine unless I could speak to a supervisor. Of course, no supervisor was there at the drawing station, but a couple of calls to the corporate office led to a form being faxed to my office, while I stood around fuming. Before it could arrive, the poor cowed clerk at the drawing station had violated her sacred HIPPA duties had sent me the lab results. She is probably being held in Guantanamo at this very moment, being questioned by federal authorities and denied access to council. (See, my 2 deputy district attorney sons never read my blog, so they can't defend the legal system they are sworn to uphold.... what they don't know won't hurt them.)

Guantanamo, the War on Terror and civil rights are not really laughing matters, nor are religious beliefs, or their infringement for political or economic gain, so that's why I wanted to be in Corona, but in this crazy mixed up world, it's important to be able to laugh at our predicaments.

How did I get from Myles to Guantanamo? From the joy of life to being so busy I don't know which way to turn, and with gratitude for the joy that friends and family bring into my life.

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