Physician – Geoff Fox: My Permanent Record

Pretend It’s Your IQ

For those who don’t know, an annual physical has a lot of simple tapping, touching and listening and the… well, let’s just say one part of the exam is extremely unpleasant.

The sign on the scale at my doctor’s office says, “Pretend it’s your IQ.” Mazel tov. I’m smarter! The increase in my weight was less than I feared and the only bad news with today’s trip for my annual physical (14 months–but who, except my physician is counting).

These exams started a few years ago for me. Mainly the results are fine. I have the typical changes an aging boy sees. From time-to-time some tests have had to be repeated, but the second result is always within reason and I’m patted on the head and sent on my way.

I asked for a lollipop as I left today. They have none.

A few years ago as my doctor and I were talking about some minor bump he blurted out, “It’s not cancer.”

Until that moment the thought of cancer had never entered my mind–never. Now I can’t not think about it.

For those who don’t know, an annual physical has a lot of simple tapping, touching and listening and the… well, let’s just say one part of the exam is extremely unpleasant. Other than that my blood pressure and lungs seem OK. My legs pop forward when hit with a mallet. I have no unexplained aches and pains.

Actually, there’s still one more piece of this medical puzzle to come. Tomorrow I’ll skip breakfast and head to the lab to get blood drawn. There are vials to be filled so more tests can be taken. I’m confident those will be fine as well.

To paraphrase my doctor I’m in excellent shape for someone of my age. Though, honestly, who wants to be my age?

Michael Jackson

Martin Mull tells a joke about the saddest thing in the world–high school with money. Michael Jackson was that on steroids!

As we sat on the couch yesterday afternoon Helaine said, “I’m surprised you haven’t written about Michael Jackson. I checked a few times looking for it. Don’t you remember sitting on that ugly couch in Buffalo watching Thriller?”

I do. It was quite an event. The world gravitated to MTV on December 2, 1983 when the video was premiered. There was as much hype and hoopla as I can remember surrounding a cultural/musical happening. It didn’t disappoint.

This was Michael Jackson’s second pop career. His first was as the front man for the Jackson 5.

When the J5 was at its peak they were being marketed in a way that made them seem unhip to me. It’s only now I appreciate songs like “I Want You Back&#185.”

When I speak to people who’ve only seen Michael as a grotesquely reconfigured weirdo, I point out that he was genuinely cute pre-surgery. It’s tough to believe.

I’m not a psychiatrist, but I still have my theories on what made Michael Jackson the truly strange person he grew up to be. I don’t doubt he enjoyed the time he spent performing. Unfortunately, that time is surrounded by more dedicated time. As a child his life was full of adult responsibility and discipline.

Look who he’s friendly and linked to–other grown child stars. They’re the only people who might have a true understanding of his childhood… or lack thereof.

On top of that, imagine a life where money is truly no object. Martin Mull tells a joke about the saddest thing in the world–high school with money. Michael Jackson was that on steroids!

It’s all really sad. I don’t feel especially bad for the family whose motives have always seemed a little sinister to me. I do feel bad for Michael who never had the ease of life that his level of fame is supposed to provide.

Last night I decided to look and listen to some of Michael’s stuff. That took me to youtube.com where loads of performances can be seen. Actually, there’s more! I have no idea where it came from, but within youtube are the original Motown tracks for some of the Jackson 5 songs minus the lead vocal. It looks like these were mastered to allow Michael to appear on TV or in person actually singing, but without the expense of the sending a full orchestra (actually the Funk Brothers) and the rest of the family. It’s amazing stuff to hear.

As we change from the vinyl to digital era and radio fades from its glory there may never be another artist capable of aggregating the outlandishly huge fan base Michael got. Mass media is become narrow media which doesn’t play into this kind of over-the-top fame.

Saturday afternoon word came the physician in Michael’s house when he died has ‘lawyered up.’ People will go to jail for this tragic death.

&#185 – The piano glissando in “I Want You Back” has reached iconic status.

The Cardiologist Tells My Dad To Wear A Halter

In November he walked effortlessly through the streets of Las Vegas. He is the picture of 83 year old health. I worry anyway.

See embarrassing addendum at the end of this entry.

I called my mom as I got into the car for my ride home tonight. We speak most evenings.

“We went to Dr. Saltzman,” she said.

My parents go to the doctor’s office like most folks go to the grocery store. In South Florida there are specialists for every body part and bodily function. This doctor is the cardiologist my dad sees.

“He noticed something on the cardiogram,” she continued.

It was 11:40 PM when I spoke to my mom. Either I was an afterthought or she didn’t think this was pressing.

She went on to explain my dad would wear an instrumented halter for a day and the doctor would make decisions based on that.

Here’s where my generation and my folks depart. I asked my mom what the doctor said the problem might be and what would be the treatment? Nothing. My parents asked no questions. How can you not be curious in a situation like this?

I know my dad will read this first thing in the morning, so let me make perfectly clear, I understand it’s a generational thing. Their generation was brought up not to question those in authority, whereas my generation… well this is a photo of my generation in action questioning authority. I spent the better part of a decade doing nothing but questioning authority!

My dad is a miracle of medical science. His arterial plumbing has been cleaned and rerouted in the past. In November he walked effortlessly through the streets of Las Vegas. He is the picture of 83 year old health. I worry anyway.

Were the shoe on the other foot I would not be so sanguine. I would ask more questions. But in the end, like my dad, I would place my faith and fate in the hands of others.

—————-

Embarrassing addendum:

Tonight, my friend/physician Steve sent the following:

In the piece about your father, the cardiologist almost certainly DID NOT tell you dad to wear a ‘halter.’ If he did, his man boobs would probably stick out. What he more like was told was to wear a HOLTER, as in Holter monitor. That’s a device that records the heartbeat for as long as you wear it (typically 24 hours) to look for abnormal heart rhythms.

Holter, not halter. Different spelling. Different concept.

Sturm and storm.

My Girl Has A Hurt Wing

In many ways the Internet has made the life of a physician more difficult. By the time Helaine spoke to him she had already read a bunch of web sites where the worst effects of a tetanus shot were discussed and described

Our family physician. Steve, reads my blog. That’s why he let me know Helaine’s cuts warranted a tetanus shot. She took it today. Her right arm, which she wasn’t able to sleep on anyway, is now more sensitive.

We’ll take a few days off before returning to Sleeping Giant. I’m sure the mountain will wait for us. Hopefully the skittishness I expect her to have–returning to the scene of her spill and all–will be short lived.

The Disappointing Doctor

Then there’s the Robert Jarvik we see in the ads. Dr. Jarvik is in his early 60s. He is shown, out alone, rowing a racing scull. It’s not really him. It’s a more physically fit body double!

Dr. Robert Jarvik, inventor of the artificial heart that bears his name, is taking heat for promoting Lipitor in TV ads. It was a story on Good Morning America and in the New York Times this morning and on our newscast here in Connecticut tonight.

There are a few problems with Jarvik’s TV spots. Though a degreed physician, he has never practiced medicine or is even licensed to practice.

His recommendation might be from the goodness of his heart, but the fact he earns well over $1,000,000 from Pfizer, Lipitor’s hard to spell manufacturer, makes it suspect at best.

Then there’s the Robert Jarvik we see in the ads. Dr. Jarvik is in his early 60s. He is shown, out alone, rowing a racing scull. It’s not really him. It’s a more physically fit body double!

I have a vested interest in this whole affair. I take Lipitor every day. My dad had heart disease and I’m hoping to minimize my risk through chemistry.

I don’t want to think it’s being sold like a burger at McDonalds or new car. This is, after all, medicine. It should be sold because it works best, not because it’s immensely profitable.

Lipitor aside, I don’t like seeing prescription drugs marketed directly to consumers. I don’t need to hear about oily discharge or erections lasting longer than four hours.

I spoke with my friend/physician Steve last night. He doesn’t like this either… but we’re too late. I can’t imagine turning back the clock on this recent form of consumer commerce.

Thinking about Dr. Jarvik and this story reminded me of something I’d heard years ago. I went online to check it out.

Dr. Jarvik owes much of the success of his artificial heart to the work of a medical trailblazer – Paul Winchell.

Something of a renaissance man, Winchell was also an inventor who held 30 patents, including one for an early artificial heart he built in 1963 and then donated to the University of Utah for research. Dr. Robert Jarvik and other University of Utah researchers later became well-known for the Jarvik-7, which was implanted into patients after 1982.

In case you’re too young (and seemingly, everyone is nowadays), Paul Winchell was a ventriloquist. With his characters Jerry Mahoney and Knucklehead Smiff, “Winch” was a staple of 50s and 60s TV.

He was also the voice of about a gazillion cartoon characters, including Tigger in Winnie the Pooh.

I thought it was OK for Paul Winchell to pitch Tootsie Rolls while I was growing up. I don’t feel the same way about Jarvik’s pitch now that I am grown up.

The Modern Desktop Publisher Uses Video

About two years ago, a bunch of my friends got together to make a movie for an 8 hour film contest. One of the participants was Harvey. Harvey is a physician, heavy on the research, whose specialty is getting women pregnant.

He likes to say that. Me too.

One of the things Harvey has devised is a test used to better understand why some women don’t get pregnant… and how to change that. I’m oversimplifying, but you get the idea.

When we made the movie, Harvey knew nothing about video production. Because he had Final Cut Pro on his Mac laptop, and because he didn’t know how to use it, he asked if he could be our editor!

He wanted others, people who did know what they were doing, to teach him the software. That was a masterstroke.

That afternoon, Harvey began to edit. What he did was rudimentary, but before we began, Harvey didn’t know enough to know the extent of what he didn’t know!

I got an IM from Harvey yesterday. He was working on his own video project, explaining a medical test he’s devised for IVF candidates. Would I look at it?

What Harvey brought was a little rough. You could see it wasn’t done by someone who edited a lot. But, it was easy to see there was a really good and effective presentation hidden beneath the rough cuts.

First I, then my weather partner Gil Simmons, watched the video and took notes. Most of the problems were simple things – dissolves versus cuts and how to work around shaky shots. Harvey took it all in.

The really cool part was, Harvey had gotten so close by himself. He shot, wrote and edited the whole production&#185 with no outside help.

We had dinner and Harvey headed home, hoping to begin cleaning the production up. We spoke again at 11:30 PM.

By this time, I was as anxious to make the video a success as he was. I drove to his home and spent nearly three hours with him working on graphic elements.

Final Cut Pro is an amazing product. Just using the tools he had at home, Harvey was beginning to have a very slick looking production. It will end up being burned on DVDs and put on the web as Flash video.

There is a moral to this story. The kind of production Harvey assembled could have cost well into five figures – and it would have been worth it. Now, effective video production can be done by anyone, even a multiply doctored academician from Yale!

It’s true he needed some professional help to get him on track, but he was incredibly close to success all on his own. Non-linear editing tools allowed us to manipulate the project where it needed to be with little trouble.

Video production is the most powerful storytelling medium ever devised by man. It has been democratized.

&#185 – Writing is probably the most important part of video production. A well written story is the blueprint which guides how everything is assembled. Good writers are tough to come by.

Sunday With The Folks

Last night Helaine and I slept on a blow up bed in my parents’ spare bedroom. I’m not complaining. We used to come here to Florida and sleep on a pull out couch.

You can’t spell couch without ouch. It used to kill my back.

My mom had a great breakfast for us. Bagels and lox. Pickled herring.

Hey, we’re not Presbyterians. We are not a Wheat Bran family.

After breakfast we went to visit my cousins, Carol and Howie. Carol is the daughter of my grandmother’s sister. There’s an correct term for our relationship, but in our small family cousin works fine.

One of their sons, Michael, came by. I’m related to him too, though I won’t even venture a guess what the correct title is. Michael’s a physician in the ER of a local hospital.

Yes – one of their sons became a doctor. Mission accomplished!

We went back to my folks condo, looking for something to do. Before we left Connecticut, Helaine told me, no flea markets – no shopping.

You have to understand, for my parents, going to Costco or BJs is entertainment in and of itself. We really wanted no part of that exciting South Florida lifestyle.

Helaine suggested seeing a movie. Luckily, there’s a theater two minutes away where Dreamgirls is playing.

We got there a few minutes before showtime, but waited through the scheduled start when the ticket machine ran out of paper… then jammed after being reloaded.

It’s OK – we missed the commercials and coming attractions but saw 100% of the movie.

I convinced my dad, who wears two hearing aids, to get the headphones many theaters offer. A few minutes into the movie he threw them off. That came a few seconds after he said “Too loud,” very loudly.

I went to adjust the volume, but found the theater had set their input volume so high, anything coming out of the headphones was going to be terribly distorted. There was nothing that could be done at the headphone end to fix it.

What a shame. The theater spent the money to offer this service, but by misaligning the equipment their investment is worthless. I told the young girl at the ticket counter, but I doubt that will do any good.

It’s been a long time since I’ve been to a movie that was sold out. This one was. Maybe it was the Sunday afternoon price of $5.25? We actually sat in the first row – something I’d never done before.

Now on to Dreamgirls.

Wow! I was pleasantly surprised. This is one of the best movies I’ve seen in a long time.

The true star of the movie is Jennifer Hudson. Again, wow! She can sing. She can act. When she is on the screen, you cannot look away.

I’m not an American Idol viewer, so she was new to me. Now I’m a fan.

Though there is plenty of denial, Dreamgirls is obviously based on the Supremes. Beyonce Knowles is Diana Ross. Jamie Foxx’s character is Berry Gordy.

Dreamgirls is a true musical, with much of the dialog sung (especially through the second half). There’s a lot of Motown influence in the beginning, and I was reminded how much I liked Motown music in the 60s and 70s. Much of the rest of the music is “Broadway” styled. Still, a farewell song was so reminiscent of “Some Day We’ll Be Together,” I started to hum the original at the hooks.

Most of the movie was great and none of the movie was bad. Performances by Eddie Murphy, Jamie Foxx, Jennifer Hudson, Keith Robinson and Danny Glover were superior. That’s a lot of excellent acting. How can you not credit the director for that?

Dreamgirls is stylish. It is compelling. It moves (though I’d have been happier had it been 25 minutes shorter). I really liked it a lot.

Chalk up another good recommendation from Helaine.

I Hope This Is True – Diabetes Cure

Don’t bother reading the boxed text unless you’re a physician. Even then you might skip it. It’s from the journal “Cell.”

In type 1 diabetes, T cell-mediated death of pancreatic β cells produces insulin deficiency. However, what attracts or restricts broadly autoreactive lymphocyte pools to the pancreas remains unclear. We report that TRPV1+ pancreatic sensory neurons control islet inflammation and insulin resistance. Eliminating these neurons in diabetes-prone NOD mice prevents insulitis and diabetes, despite systemic persistence of pathogenic T cell pools. Insulin resistance and β cell stress of prediabetic NOD mice are prevented when TRPV1+ neurons are eliminated. TRPV1NOD, localized to the Idd4.1 diabetes-risk locus, is a hypofunctional mutant, mediating depressed neurogenic inflammation. Delivering the neuropeptide substance P by intra-arterial injection into the NOD pancreas reverses abnormal insulin resistance, insulitis, and diabetes for weeks. Concordantly, insulin sensitivity is enhanced in trpv1−/− mice, whereas insulitis/diabetes-resistant NODxB6Idd4-congenic mice, carrying wild-type TRPV1, show restored TRPV1 function and insulin sensitivity. Our data uncover a fundamental role for insulin-responsive TRPV1+ sensory neurons in β cell function and diabetes pathoetiology.

What that exercise in ‘academic speak’ says is, Canadian scientists might have found a cure for diabetes. If true, this is amazing news.

In a more human friendly article from Canada’s National Post:

In a discovery that has stunned even those behind it, scientists at a Toronto hospital say they have proof the body’s nervous system helps trigger diabetes, opening the door to a potential near-cure of the disease that affects millions of Canadians.

Diabetic mice became healthy virtually overnight after researchers injected a substance to counteract the effect of malfunctioning pain neurons in the pancreas.

Operative words: “healthy overnight.” For families of diabetics, that little phrase is the answer to years of prayers.

You probably know I’m involved in the Juvenile Diabetes Research Foundation. I am touched by the stories of the families affected by diabetes. It’s no less tragic when it’s Type 2, or adult onset diabetes.

Children with diabetes have a life span more than ten years shorter than non-diabetic kids. And then there’s the daily trouble and worries that come with being diabetic.

Each year I say, “I hope this is my last JDRF Walk.” Maybe I’ve already walked it!

I sent the article and a brief note to Mary Kessler, who runs the local JDRF chapter.

We are all very excited-thanks for sending it on to me.

Try not to get too excited about it yet, we have had these miracles before and they did not translate to humans-but I am keeping my fingers crossed.

She’s right. Some exciting progress, using stem cell research, fizzled only a few months ago. What looked very good at the outset was just an empty promise.

Still, if there’s going to be a cure, it’s likely to start with an announcement like this one. My fingers are crossed.

The Modern Diagnosis

Steffie had a pretty bad allergic reaction this weekend. It wasn’t fun for her, or for us. Your child can grow up – but she’s still your child.

As the week went on, the allergic reaction went away. That’s good.

Our family physician said Steffie should see an allergist. I called the to make an appointment with the allergist I see… or anyone in his practice. June – the earliest available appointment is June!

Popular folks these allergists.

I wasn’t sure what to do, so I sent my allergist an email, with a photo of Steffie taken while she was in the midst of the reaction. He took a look and wrote back.

His response suggested what we were already doing was right, and it wouldn’t be necessary to see him until or unless there were more problems.

I’m glad he wrote back, but this is a hell of an imposition on my part, isn’t it? Maybe it’s time to acknowledge the new era and have our insurance companies (or, shudder, me the patient) pay for this service.

As far as I can tell, when my internist or allergist gives me advice from his keyboard, he’s doing this out of the goodness of his heart – literally giving away the work he usually charges for.

My guess is, in some cases, Internet consultation is a good thing. From an insurance standpoint, isn’t this a chance to purchase a more cost effective service for their customers? Shouldn’t the physician be compensated to encourage this?

I am not a doctor (nor do I play one on television&#185). I’m sure those I know will tell me if I’m off base here.

&#185 – That line, “I’m not a doctor, but I play one on television,” was actually used in a TV commercial about 40 years ago.

Blogger’s addendum: And, my primary physician did respond:

If there were something that were more than 100%, I’d agree with you that much. Does the accountant or lawyer or guy at the gas pump EVER give it away for free? I think that our ethic and culture is different, though. Medicine is rightly called a “caring profession.” and when we care, we really do care. So we do it, without listening for the sound of the cash register ringing.

And don’t hold your breath waiting to hear that Aetna or Anthem or, God forbid, Medicare will ever pay me or your allergist for giving you email or even telephone advice. Not in my lifetime, and I plan to torture all of you for many years to come.

Why Does The Phone Ring At 7:30 AM?

OK – I’ll admit it, I’m spoiled. When Helaine gets out of bed in the morning, she closes the bedroom door. That leaves me in a room with a phone… but with its ringer silenced.

There’s no such protection here in Florida at my folks condo. In fact, the size of the cordless phone, sitting in its charger, belies its ability to shriek. It is LOUD!

The phone began ringing at 7:30 AM. My parents photo was in the Palm Beach Post. Friends and neighbors wanted to make sure they knew.

The article was about their physician, who has begun to charge for the privilege of being his patient – regardless of how often, or even whether, you visit his office&#185.

Amazingly, they were pictured, but not quoted!

When the photographer visited my parents he asked them not to smile. That worked. They look positively glum.

Is that slanting the news? Their photo certainly doesn’t make the doctor look warm and fuzzy. But, even without quoting them, the photo perfectly represents how they feel about the whole affair.

The day has begun. I’ll be looking for an opportunity to nap later. Please don’t call.

&#185 – I wrote about this last August when it first came up.

Good Day To Be Me

I’ll start with an admission. This won’t be my most exciting of entries. It wasn’t an exciting day.

It was a good day… and an unusual day. I had two meals with two friends. I eat dinner every night, but the fact I had lunch at all was out of the ordinary.

Lunch was with my friend Josh. publisher of a string of weekly newspapers.

I woke up ‘early,’ around 11:00 AM, driving to New Haven at 12:45 PM. Today was a day with astounding weather. It got over 60&#176 at my house and well into the 50&#176s in New Haven (closer to Long Island Sound). For mid-February in New England, this was a bonus day!

Normally, in February, I’d park in the garage under his office building. Today I drove to the TV station, parked in our lot and hoofed it the five or six blocks under the Federal Building and past the New Haven Green.

The streets were crawling with people. It was like a spring day and anyone with any kind of pent up winter blues was outside.

The happiest person I saw was the hot dog vendor on Church Street, outside the (usually unoccupied) WVIT – New Haven studio. I’m not sure if the hot dog guy’s out there year round, but if he is, he can’t be this busy most days.

Josh and I had lunch at Basta, an Italian restaurant on Chapel Street. I chose mine from the daily specials the waitress read.

I can’t remember exactly what it was I ordered, though it did have chicken sausage over penne pasta. I do remember, there was so much ‘range fed’ this and ‘organic’ that in her description, I felt ordering it would also commit me to vote for Ralph Nader (if he ever runs again)!

Lunch, and luncheon company, were very good.

I walked back to the station. On the way, a few people stopped me to say hello and kid me about the weather. If there was ever a good day to be the weatherman, today was that day.

Through the afternoon I thought about how I’d avoid dinner. Lunch was plenty. Then, my friend Harvey came on Instant Messenger.

Harvey is a physician – a specialist in pregnancy&#185. Every time I introduce him to someone, I say Harvey gets women pregnant for a living. It’s a cute line and Harvey has never asked me to stop saying it.

We headed out for dinner at the diner – salads.

We both talked about our girls – he has three to my one.

It’s so strange to me to be having these grown up conversations with other grownups. But, I suppose I am one and there’s little I can do to change that.

Actually, at lunch, Josh and I had a similar adult-ish conversation. Growing up is sneaky. I don’t feel old, but when I look around I know I’m older than most of the people I see. And, my life revolves around adult responsibilities.

I just don’t remember exactly when I grew up.

&#185 – Harvey’s medical specialties also includes women’s orgasms. There is no joke here. That’s a heck of a thing to be known for.

Nearly Childless

Now that Steffie is at school, Helaine and I are nearly childless. We can come and go as we please (as can Steffie, much to our chagrin).

Last night we went out to dinner with another couple and went to an adult restaurant. I’m not going to give their names, and you’ll understand why later.

The restaurant was Le Petite Cafe in Branford. It is a tiny place on Montowese Street, adjacent to the Green. It is tied with another restaurant for Zagat’s highest rating for Connecticut.

It’s small enough that I missed it as I drove by. It was only through Helaine’s diligence that we stopped.

Dinner was excellent. I had a chowder appetizer and lamb for the main course. Both were wonderfully prepared and very tasty. What’s not to like?

Though the restaurant is small, there are two seatings. We were there for 8:30, which is an early breakfast for Helaine who is normally in pajamas by then.

As we finished our main courses, the husband of the other couple started looking uneasy. A quick glance down showed he was taking his own pulse! He’s a physician, though most of his work is research and certainly not centered on anything his pulse would enter into.

He wanted to go to the car and lay down, but we weren’t hearing any of that. I gave my credit card to the waiter and walked him to the car. A few seconds later his wife climbed in and drove him to the Emergency Room at Yale/New Haven Hospital.

They were still there when I spoke to them this morning. His tests have come back fine. He’s still feeling achy and tired. He’s good enough to go home… but not good enough. There’s something going on with him that wouldn’t normally be checked for at the ER.

He’ll find whatever it is and he’ll be fine. Of this I have no doubt. But, it’s scary for all of us.

Today was another day with nothing to do. Helaine and I climbed into the car and drove to Foxwoods.

There are two casinos in Connecticut. Only this one, Foxwoods, has poker. At one time they both had poker rooms, but Mohegan Sun closed theirs about 20 minutes before the big poker boom hit America.

With no child left behind, we’re staying at one of Foxwoods high rise hotels. Like Mohegan Sun, this is a beautiful resort hotel. The rooms are every bit as nice as anything you’ll find in Las Vegas… though the view out the window is decidedly Eastern Connecticut.

Unless someone told you, you’d have no reason to suspect places like this existed in Ledyard and Uncasville, Connecticut.

I sat down almost immediately and played cards for a few hours. Then, it was dinner time.

Helaine had made reservations at Cedars, the steakhouse. We showed up at 6:30 and waited about 20 minutes. OK, that’s not a long wait, but 6:30 is 6:30.

The food was worth the wait. I had chowder (again) and a steak, prepared Pittsburgh (charred outside, rare inside). Between the soup and a side dish of potatoes, I decided dessert wouldn’t be necessary for me and Helaine concurred.

I headed back to the poker room for some more play.

This was a very good day of poker. I’ve said this before, but it’s worth repeating. Whatever insight or skill I bring to a brick and mortar casino, I owe to my low stakes online play.

Years ago I thought I was a pretty good poker player. I was not. Now I’m decent. I can keep my head above water at the stakes I choose to play.

Today I was conservative and measured. Patience is a poker virtue.

I only had one bad beat, though it was a doozy. I went in with a Jack and King of Spades. The flop came with 3 more spades – I had a King high flush!

The next card, the turn, was a rag (no help).

Then came the river. That final card was another spade. I was set to beat any other hand, except one that had the Ace of Spades.

I knew the two cards in my hand and the five on the board. That left 45 unknowns The one person playing against me had two cards. So, the odds were 2 in 45 he’d have it.

Ouch. This was a very expensive hand to lose. Still, the day ended quite positively.

How much better could I do? Not much, I figured. So, at 10:30, I went up to the room for the night.

I am going to work tomorrow, but there’s an 8:00 AM tournament and I think I’ll get up early and play.

My Parent’s Doctor – II

I got two interesting responses to my entry concerning my parents’ doctor and his new $1,500 per person yearly fee. One was from doctor/friend Steve… and I’m waiting his OK before I put it here.

Here’s another from a friend in South Florida (who does not have a shift key on her keyboard).

there’s been a lot of coverage down here about this kind of thing… it’s legal… and the bottom line is that your parents do have a choice.. pay up or find another physician.

sucks, of course. but it’s not aimed at your parents.. it’s aimed at wealthy people who don’t want to deal with a dr’s office with delays and hassles. by slimming down his patient base he gets (so the logic goes for the doctor) more quality time to spend with patients.

it’s the difference between buying a lexis and a yugo…. better waiting rooms, loaner cars, more customer service. you pay for what you get.

She’s perfectly correct, but, to me there is a moral contract that’s entered into when you become my physician. My parents aren’t just changing doctors, they are being extorted in order to maintain a relationship with the only professional totally familiar with their medical history.

If he had done this when he opened his practice, or if this only applied to new patients, that would be OK. But, he is changing the rules of the game while the game is on and I think that stinks.

My Parents’ Medical Care – Not Well

My sister popped up on IM tonight. I couldn’t hear her voice, but I could sense she was upset. I’m not sure how that works in a few short typed words, but I knew. I picked up the phone and gave her a call.

She had spoken to our folks earlier in the evening and was upset. By the end of the call I was upset too.

Their doctor… their internist… had decided to affiliate with a program called MDVIP. Basically, in order to stay patients of his they would have to pony up $1,500 per year each.

The $1,500 would buy them an examination and wellness program. The bottom line is, they would receive similar care, still paying for each visit under Medicare, at an additional cost of $3,000.

The physician said this would allow him to limit his practice to 600 patients. Well yeah! Because his end of the $1,500 is $1,000 ($500 to MDVIP). Six hundred patients is $600,000 per year, plus whatever he charges to be a physician.

My blood is boiling because I consider this medical extortion. To me (though probably not to our legal system) this plan allows doctors to charge more than they are allowed to charge under Medicare.

Maybe I’m too naive – a babe in the woods. Grow up! Get with the program, Geoff.

A few years ago, Senator Bill Nelson of Florida got involved.

Nelson has introduced legislation in the Senate, S. 1606, that would prohibit doctors who charge access fees from also billing Medicare for their services. “If this practice continues to spread, it could mean the end of Medicare,” Nelson said. His legislation doesn’t address people covered by private health insurance. It would be up to the insurer whether to allow doctors in its network to charge consumers such fees.

The fact, three years later, my folk’s doctor is doing this, says Nelson failed.

Maybe I’m missing something? I dropped a note to my doctor/friend, Steve. No answer yet, but I’m anxious to get his read on this. After all, he’s on the other side of the stethoscope.

My Favorite Misconception

It used to be all I had to worry about was that rumor I colored my hair. Nope – never. I’ve got lots of gray sprinkled in there, but it just isn’t seen on TV and I’m not sure why. But the rumor persists.

Tonight I got this email from my friend/physician Steve with new rumors.

He said you’ve only got your job “because your family owns the network.” When I pursued this further, he told me that your family owns the Fox Network (it should only be, right?)

When I pointed out that WTNH isn’t part of the Fox Network AND that I happen to know your father and (1) he hasn’t got that kind of money and (2) his name isn’t Rupert Murdoch, he stopped. For a moment.

But then he said, “and [your] father-in-law is Dr. Mel!!!”

Does Helaine know that? Did you? I asked where he got this information and he said he heard it a long time ago. I told him that I knew for a fact that he was wrong about that, too (he either thinks that you’re really young or Dr Mel is much much much older.)

Isn’t this crazy? That’s the first I’ve heard about the Fox Network, but I get the Dr. Mel father-in-law question all the time. Both, of course, not true.

Where do these things get started? In fact, why would anyone care enough to start something like this?

I often worry about the hair coloring rumor, because I don’t want people to think I’m trying to scam them by being something I’m not.

I visited the Fox lot this summer. trust me, if I owned the network, I would have had a much better parking spot.

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