Sunday, January 17, 2010

Day 4

I already know what I'm writing about today and I'm still sipping coffee #1. First, thanks to everyone that has been reading. Thanks to everyone that wrote something. Seriously, it means a lot.

I just read an op-ed piece in the NYtimes about happiness. I'm hoping that article and my recent discovery of the poem Invictus serve as new guides for the next few years in walking on this planet.

I have some med school friends who are all freaked out about changing health care, that doctors are going to get the short end of the stick. I genuinely believe, that unless you're also doing some type of research, be it molecular biology, drug/therapeutic trials, epidemiology, etc, that doctors should receive a salary. How high that salary should be, I don't think is anywhere close to what many doctors currently bring home. In my eyes, a doctor is a public servant, more educated sometimes, but no less dedicated than teachers, firefighters, police, etc. During residency, most physicians make 45-52k/year. The whole ideal that our society has where doctors and lawyers, because of their long educational process and often large knowledge base I think needs critical examination. What if the people who went into medicine were smart and did it because they wanted to serve others? Isn't that the whole point anyway? So then, why is it that many private practicing blank physicans make 400-500k while primary care doctors 90-150k. Skill? Time? Injustice in the system? Hard work?

Would I work the rest of my life at a resident's salary (currently the reality is that I'll at least work 3-6 years at that salary)? I would if my loans are forgiven and there was also additional incentive to contribute in other ways, in my case perhaps studies in molecular biology. I suppose also, that there needs to be some increase in the salary over time, just to keep people in the system...such and such percent increase per year over baseline. If we did that and also launched a serious health campaign against diabetes (which costs our country $123 billion+ per year in largely preventable complications) our health care problem would be better. I don't claim to know very much about the insurance side of things (universal vs government run vs private etc), all I know is what I'm willing to do from my own abilities.

Back to the present. I finally got to start taking my thyroid hormone again today and over the next few days should start feeling normal again. Phew. I get scanned at Hopkins on Tuesday and will get to take a look at the image before leaving to head back to Missouri. I except that I'll see some uptake in the lower lobes of my lungs and in some discrete areas in my neck. We won't know how well the radiation worked for another 3 to 6 months. Basically this stuff keeps doing its job over time, because it has caused DNA damage and in combination with lack of growth signal (no TSH secondary to very high doses of thyroid hormone) cells should start dyeing. We'll know the extent to which via a fancy blood test at 3 months and 6 months.

As far as the altruism article goes, I still want to create/find a way to bring together something from this cancer experience, bicycles (which to me mean community, low-energy lifestyle, greenspace conservation, meditation, exercise, and racing), and doing good. The Livestrong thing is great but it has always seemed to abstract and big for me. Maybe if Lance sent me an email and went on a ride with me I'd get it!

I still don't really understand what a war on cancer means...how about a war on diabetes? That will save this country many more lives and billions of dollars. But again, I want to do something with cancer.

4 comments:

CockPuncher said...

Dan, as a diabetic I appreciate your interest. I also totally agree with you that the real issue with our country's "healthcare crisis" is in fact our poor health. Much like the "foreign oil" debate, our politicians (& the population at large for that matter) focus on a band aid approach.

We cut physical education in schools, we "privatize" public school dining rooms to make meals "more affordable" (Papa fucking Johns in cafeterias??? Are you kidding me!?!), people feed their kids shit (mcdonald's, etc) for breakfast, lunch & dinner. Then, we need to "fix healthcare" rather than fixing HEALTH. Nobody wants to give up yummy big macs.....they want cheaper bypass surgery!

Anyway.....I am going for a ride w/ Taggort today. Hope you are feeling better. Looking forward to seeing you soon.....Punchor

Martin Lang said...

Never realized all that about diabetes. I hope everything ends up well. It's hard for me to get the real picture of good/bad. With regards to Livestrong, when I was working out at Trek store we sold the clothing. We had a poster or something in the back that talked about the company, and it was something like 5% of profit from each clothing item sold went back to the company. So for the 189$ bib shorts being sold with the Livestrong band on the left leg, it wasn't 5% of that which would be about 9.50, but instead 5% of probably 120 or something like that. I know it's still doing good, but I always felt like more of a hit could have been taken by nike and the other companies involved in making that clothing. It's kind of something that has stuck with me, for better or for worse, that I always think about when I think about Livestrong.

Magda said...

you know most of the time your teachers impact your life more than your doctors. so why don't we get paid the same? yeah, docs have more schooling and training involved (aka more money spending) but i am sure that for an increase in salary every teacher out there would dedicate themselved to more training and more schooling to be better at what they do. to me, teaching is harder than medicine--its not something you can just look up in a book.

Doctor said...

Especially given that the $189 Bib shorts were made by a 10 year old in Indonesia and probably cost nike about $5 to produce.

I worked school pies at Papa Johns a couple winters ago and was amazed at what the schools ordered. The cafeteria people order what goes the fastest, and some of the schools got more cheese sticks than pizzas. You may as well give the kids a butter iv. Add that to 6 hours of video games and a couple of energy drinks to combat the butter induced lethargy and it's no wonder 12 year old kids are having heart attacks. WTF? I am not sure of the numbers, but isn't a majority of the American population obese?

On the lighter note sounds like you are getting in some rides and staying positive, keep it up.

DR.