Sunday, October 26, 2008

What do you need ....a banner that says hey I'm dead!!!

So after three apnea tests (all verifying brain death), the cholinergic tests (all verifying brain death), several eeg's (all verifying for brain death) the doc refuses to declare the patient brain dead becasue he may or may not have seen some minute possible, (most likely imagined) millimeter of eye movement. No shit. So we keep the dead guy alive on a vent, all the while giving the wife false hope, and at the same time maxing out her Visa.

We here in Neuro icky u hate this. We begin to hate the paitent. We totally hate the doc. And no one has the balls to over rule the doc and walk in to the wife and say "dammit, man's dead - pull the frggin' plug." For twenty seven days we play this hellish game - only to finally transfer him today to a long term care unit. Can you believe that?

Wht the hell does the doc need to verify brain death??? A friggin banner over the guys head? Does he need the patients ghost to come tap him on the shoulder? Does God himself need to come down and tell him to knock it off?

And what is really chilling is this is a new doc, now working in Neuro a lot (where, by the way there is a LOT of death and end of life decision making) - and apparantly a psycho doc who has end of life issues . God help all his patients from now on.

Sunday, October 5, 2008

What happened to personal responsibility?

I was watching a tv the other night. Some documentary on how the health care system fails the "average person". They showed this man ... this whale of a man - 450 pounds I think they said. He was uninsurable (they didn't say why he was uninsurable, just suggested that the wicked evil no good greedy insurance companies wouldn't insure him.) He had diabetes, a bad heart, cellulitis, gangrene in his foot, hypertension, and every other malady that comes along with morbid obesity. My question is this? Why the hell is he 450 pounds and whose fault is that? If he chose to be 450 pounds (which apparently he did) then isn't his health his problem? Why should insurance companies insure you if you have a lifestyle that will inevitably cost them money? And who ultimately pays for that? You and I jack - in one form or another. Either we pay higher premiums to compensate or higher taxes for federally subsidized programs

I had a patient bragging about how good her health insurance is. "They paid for my glasses, They paid to get all my teeth fixed. I only pay 3 bucks for a prescription and only a max of twenty bucks a year. I don't pay nothing for the emergency room or the hospital...." Perplexed I say "wow - what insurance do you have?" She replies "I'm on Medicaid!" I had to bite my tongue because I wanted to scream. So because she has smoked like a chimney and now has advanced COPD at the ripe old age of 40, she is on disability (which we pay for), she gets to sit at home and smoke more while I work my ass off, and they ravage my check to pay for her health insurance to pay for her health problems that SHE caused AND I pay a shitload for my own health care insurance AND she gets better benefits than I do!!!

That is what's wrong with government running health care.

There is no responsibility factor. There is absolutely no incentive to work, stay healthy, or not visit the ER unless it's a real emergency. There are no co pays, and only minimal prescription prices. There is nothing that curbs massive widespread use and abuse.

I don't have any solutions. I just feel used.