Health care blues

We had a discussion yesterday on the Affordable Care Act and how it affects women's health care, especially contraception.  I left the talk totally depressed.  This was further amplified by watching the 3rd presidential debate last night. 

I recognize that the ACA is not perfect, but it is a HUGE step towards affordable and comprehensive health care in this country. I believe that health care is a right, not a privilege.  I also know that we can not continue to afford the rising cost of health care as we can't even currently afford it.  I'm sickened by the fact that politicians play political chess with people's health.  I can not understand that level of disregard for another humans welfare; but I guess that is why they are politicians and I'm a (future) health care provider.

In the discussion yesterday, we were shown a slide from the New England Journal of Medicine article "A watershed election for health care (2012)".  The chart dives up the likely results to the ACA depending on the election outcomes.  It is no shock that Romney winning would be a very large step back for health care in the US (a long with LGBT rights, abortion rights, and so many other things), but what did give me pause was what happens if Obama is reelected with a republican house and senate.  "Maintenance of near pre-ACA levels of uninsured Americans; no substantial growth in levels.  Less aggressive implementation of ACA health system provisions".  Shit.  So basically more political chess with people's lives at stake.  Nothing will be accomplished, will still be stuck in the middle of nowhere.  Lovely.

Needless to say, I'm very worried about this election.

I am also so grateful to be an insured American with unlimited access to quality care. This year off from medical school has been full of many more doctors' visits than I would have imagined. After the horrible car accident with trip to the emergency room this summer, I'm now dealing with a whiplash, a pinched nerve (upper trunk of my brachial plexus), and radiculopathy. Weekly chiropractor appointments in attempts to fix that. I'm also finally address my chronic anemia, fatigue, and constant general yuckyness by figuring out the trigger. A round of visits to a GI and a abdominal CT have ruled out my celiac as the culprit. [Even if I did read my CT as having a "speckled colon and a titled uterus" - thankfully a radiologist who actually knew what he was reading righted my incorrect paranoid diagnosis.] Good to know that I'm not being accidentally glutened. The GI's answer to this was that I'm probably allergic to something (or many somethings) and so I should take a low level steroid to blunt my immune system. Um, no thanks. I'd rather just figure out what the cause is so that I can avoid it. So, today I am finally getting much need allergy testing. Thank G!d that my comprehensive trusty health care insurance is along for the ride.

Voting for Big Bird

Last night's presidential debate was awful.  Romney was totally charismatic in an absolutely condescending way.  I couldn't decide if I wanted to hug him, or slap him.  I also kept imagining a thought bubble of loose associations over Obama's head.  I am not sure where he was but he clearly was not present at the podium. 

There were nonsensical sentences.  There were long run on thoughts that led in a circular manner towards nowhere. There were lies and empty promises followed by more lies.  The discussion was harder to follow than those of my floridly manic patients when I was on my psych clerkship!

There was one sentence in particular that sat very poorly with me though: "I would like to take the Medicaid dollars that go to states and say to a state, you're going to get what you got last year, plus inflation, plus 1 percent, and then you're going to manage your care for your poor in the way you think best."  Let us just quickly look at two case examples.  Alabama wants to take care of their poor by using medicaid as the sacrificial lamb for their budget issues.  Louisiana took care of their poor by cutting $329 million from their state healthcare, and by closing one of the state's 3 psych hospitals, likely adding more strain to the hospital and jail structure.   Two shinning examples of how one should take care of valued citizens.  I totally feel confident that allowing states to have sole decision making power on the nations healthcare will solve all our finical issues and improve the health of ever individual American... Not.

I'm voting for Big Bird.  I'm voting for ObamaCare.  While not perfect, it is a start.  I have to believe in something.

6th Annual Women Leaders in Medicine Awards and Reception

"Do you know a female physician who is changing the world?
Nomination Submission Deadline: October 1, 2012 (5pm ET)

The Women Leaders in Medicine (WLIM) awards were created by AMSA in 2007 to recognize women physicians and educators who are changing the face of medicine through their lives, their professions, or their teaching. These women deserve recognition for their accomplishments and dedication to fostering tomorrow’s women leaders in medicine.

We are currently accepting nominations for the 2013 WLIM awards. All medical and premedical students are encouraged to fill out the simple online form and tell us about an inspiring woman who has influenced the student's medical career. They could be professors that you’ve had or they could be women who you have never met but have impacted your careers through their amazing work.

The recipients will be invited to attend the AMSA Annual Convention in March 2013 to receive their award at a special reception. Many of our past awardees have considered their Women Leaders in Medicine award a truly meaningful honor because it comes directly from the voices of students. At AMSA, we hope to give back some recognition to these amazing women in addition to generating awareness about the importance of fostering leadership in medicine that promotes healthy change and equality in care and professional opportunity for all physicians-in-training.

This year will be an extra special reception as it will coincide with the International Federation of Medical Students’ Associations (IFMSA) 62nd General Assembly in Washington DC. In honor of this momentous gathering, special attention will be paid to nominees who have had an impact on the global stage. We hope you will join us at AMSA's Annual Convention for the Annual Women Leaders in Medicine reception as we announce this year’s recipients!"

http://www.amsa.org/AMSA/Homepage/Events/Convention/WLIM.aspx

Step 2 CS

I'm taking step 2 CS this weekend.  I keep waffling between feeling completely confident in my ability to rock it, and totally scarred that I'm going to majorly f*ck up somehow and screw myself over.

I did more than fine on my school's OSCE exam.  I did well with all my 3rd year clerkship rotations.  I've had 3 years of practice with standardized patient encounters.  I know how to speak English and have a decent amount of empathy. 

Yet, I haven't touched an actual patient in 2.5 months.  I have no real motivation to study, working through First Aid for CS at a snail's pace... not sure I'm going to finish it before the exam.  Concerned I'm going to forget how to take a comprehensive history, come up with a differential, or write a note.

Ugh!  Medical school = one humbling hurdle and/or act of hazing after another.  I can do this, right?!

Right brain approach to healing

(image is a Mercedes-Benz add, taken from http://www.andrewkeir.com/right-brain-vs-left-brain/)

Science is often though of as a left brain thing.  Art is the right brain.  But what happens when you combined them?  What happens when a man with brain cancer begins to think outside the box?  What happens when the man has the ingenuity and skill set to crack code, redefine healing and cure, and appeal to a larger, global, audience?

You have Salvatore Iaconesi.  You have an OPEN SOURCE CURE.  In his poetically beautiful words, here is his plea:

"There are cures for the body, for spirit, for communication.

Grab the information about my disease, if you want, and give me a CURE: create a video, an artwork, a map, a text, a poem, a game, or try to find a solution for my health problem.

Artists, designers, hackers, scientists, doctors, photographers, videomakers, musicians, writers. Anyone can give me a CURE."

This is an absolutely beautiful reinvention of medicine.   This is the art I am proud to be learning, practicing, and bearing witness in the lives of all my patients (past, present, and future).   

There is a big purple elephant standing in the corner of the US healthcare system

In simple terms, IOM stated today that US healthcare sucks.  It is about time someone addressed the elephant in the room.

"In a lengthy report out Thursday, the IOM wrote that U.S. medicine wastes roughly $750 billion per year, permits tens of thousands of needless deaths and bungles its mission in ways foreign to other industries." -The Hill's healthwatch blog commenting on the IOM report released today

Existential Crisis

My research year has started like this: 4 weeks of work (in which my grandmother died & my car was totaled), followed by 2 weeks abroad for a conference, followed by a week road trip with my girlfriend. 

This week was my first week back, and the first week where it became clear that I'm here to stay, at least for the year anyway.  This week was also slow.  Painfully slow.  S-L-O-W.  I felt like I wasted hour after hour, day after day, doing absolutely nothing productive.  Research projects are in various stages of stagnation for various reasons- mostly sitting on other peoples' desks waiting for their necessary contribution.  I know, I know, this is the way research rolls.

Too much free time spent surfing the inter-webs meant that I began questioning my decisions.  Why did I decide to take a year off?  What if waste this whole year and get nothing accomplished?  What if I walk away with no abstracts and no manuscripts, nothing tangible to show for my year?  How many hours can I really spend on facebook, words with friends, and the sudoku app before I kill myself from going stir crazy?  I'm just slowing down my life- an extra year before I potential don't match in OB (even having taken a research year), another year in a long distance relationship (if it survives distance) with a megaphone of a biological clock, another year before I can settle down in one city and actually began making a real community... another damn year!

I'm still hoping this was the right choice.  The opportunity to live in a kick ass city.  A year to have some free time with priorities on improving my health and learning Spanish before residency.  Maybe I'll finally get around to fine-tuning my basal rates after 16 years on an Insulin pump!  A chance to reconnect with my Jewish identity.  A chance to engage in some pretty novel, and interesting, research with some of the best in the field. 

For now though, I'm hoping a restful shabbos will silence my existential questioning.