Thursday, 12 July 2012

Thank you, TTC

Thank you, Toronto Transit Commission.

Thank you for increasing fares every year. I don't need that extra $100 anyway.

Thank you for being reliably unreliable. It keeps life interesting, and I enjoy the challenge of coming up with new excuses for being late for work, because "There were problems with the TTC" is getting old.

Thank you for cancelling express bus service when it snows. Apparently snow is uncommon in Canada, and you're not sure how to deal with it.

Thank you for walking out on the job on what promises to be a hot, muggy, smoggy Monday and leaving 700,000 customers in the lurch. I understand the janitors are unhappy with some scheduling arrangement, so it's only just and fair that all bus drivers, subway and streetcar operators go on strike. After all, this is what early union organizers fought and even lost their lives for: the right to an unbridled sense of entitlement, the right to provide the lowest level of service for the maximum wage, the right to be passive agressive assholes when things don't go your way.

Bravo. Well done.

Thursday, 8 December 2011

Cool Quotes

Confucius: Choose a job you love, and you will never have to work a day in your life.

John F. Kennedy: The time to repair a roof is when the sun is shining.

Henry Ford: Nothing is particularly hard if you divide it into small jobs.

George Carlin: Some people see the glass half full. Others see it half empty.
I see a glass that's twice as big as it needs to be.

Anonymous: A committee is a life form with six or more legs and no brain.

Construction and Reconstruction.

Just yesterday I received an email notice stating that some pins used in total knee replacement are being recalled by the company. Lucky for me, I have never used these pins during surgery. However, this and notices like this are a wake-up call to me and others regarding our routine use of man made materials in a human person.

So many people suffer from conditions for which we have no good solutions. What we don't know in medicine so dwarfs what we do know. But people do not want to hear this. What they want is for me to tell them "We can fix that. We can make you 100% again."

Fact is, there is no such thing as making someone "100%. " And what is One Hundred Percent anyway?

An old medical joke comes to mind:

Patient: "Doc, after surgery, will I be able to play the violin?"

Doctor: "I don't see any reason why not."

Patient: "GREAT! Cause I've never been able to play before!"

While we as physicians have come a long way in treating painful and dangerous conditions, we are simply human. We aren't magicians. But the perception of physician as magician, or shaman, persists. There must be some magic formula, some "laser surgery" that can cure our patients. More than one patient of mine has come to the office demanding an MRI. These folks believed that an MRI (which is a diagnostic test, used to find out what might be wrong with someone in certain conditions) would cure them. Cured by a test!

Perhaps we can apply the Heisenberg uncertainty principle to disease. Perhaps the hunting for them or the studying of them can knock the disease processes out of their orbits. Just enough to cause a spontaneous cure.

If only.

Truth is, we can do what we know how to do. We can continue to research problems and find new and better solutions. We can think and try and hope. We can believe that one day we'll be smart enough to tackle the toughest problems and to bring our patients back to that One Hundred Percent level.

You see, doctors want to help. We become frustrated when we can't. And sometimes, in trying to help we make things worse. By inserting faulty pins. By performing surgeries that don't come out as we had planned. By doing what we know how to do since we aren't smart enough yet to know how to fix the problem.

Sometimes the hardest thing to do as a physician is to admit when we don't know. Perhaps a course in humility ought to be added to our medical school curricula.

Married at Eight Thousand Feet.

Maya was married this weekend. her folks live in Golden, Colorado, near the grave of Buffalo Bill. Elevation at their home is almost eight thousand feet. This means there's 20% less oxygen in the air. So sea level people like me need to breathe in 20% more to feel normal. I found my heart racing after I ran up a flight of stairs!

Maya is my best friend from my residency program. She was the first person I met when I went to Rochester, MN for my interview. Two years ahead of me in training, she left for fellowship in San Diego after my third year. Now, she's a well-known Pediatric Orthopedic surgeon who works at Children's Hospital of San Diego.

She met her husband, Dan, at a Christmas party a few years ago. It was practically "love at first sight." He's a terrific man and has an extraordinary 11-year old daughter, Haley. Here are some photos from the weekend and the wedding. Maya wore the same dress (remade of course) worn by her great grandmother, grandmother and mother. The dress is more than 100 years old! Each time it has been remade slightly since each woman had a different shape. The material had aged to a beautiful gold color.

Maya's parents, Kitty and Rock, have a home in the woods which overlooks beautiful, snow-capped mountains. Numerous bird feeders set around the perimeter of the house attract all sorts of birds. It is mating season for the hummingbirds, so we saw scores of them, dive bombing all over the place. Also, the neighboring herd of Bison had just delivered some babies. All things bode well for this marriage.

Congratulations, Maya and Dan! I am honored to have been a part of your wedding and I wish you the very best.

Boys will be...

So yesterday I met the Stephens for dinner downtown at Gusto. After having cycled more than 100 miles up and down mountains on Saturday, I was in the mood for some pasta.

As always, we had wonderful conversation, great food (even though Stephen could likely do better himself!) and a little show and tell. They had just purchased an antique fire hose nozzle at a shop nearby. What they plan to do with this thing, I do not know.

What I do know is that it weighs a ton and, aside from it's overt, er, symbolism, it's a fascinating piece of equipment. Steve filled me in on the various settings used to extinguish a fire or to blow down a door.

Then I began to think about fireman and what drives them. Sure the very first firefighters didn't have fancy hoses and trucks. But somehow they felt compelled to lay aside personal safety and rush towards things that were on fire. And I'm sure that early firefighters were: 1) less successful at extinguishing fires, and 2) more likely to be injured or killed.

Firefighters don't make a lot of money. They aren't in search of the limelight either. These are truly brave, selfless people. For sure I would not want to be a firefighter. I'm scared to death of fire, for one. But wouldn't it be nice if we all could infuse a little of those firefighter qualities into our own lives?

What if the lawyer decided to work for free for his poorest clients instead of turning them away? What if the world-famous surgeon, who no longer accepts insurance plans, took on patients despite their financial status and considered only their need? What if the Deli owner gave out water to elderly or homeless people for free during heat waves?

I'm sure we can all think about something we could do so that little kids would want to be like us. Why not do it? Just a little.