Saturday, March 22, 2008

Blood Work

I always see them at the hospital -- phlebotomists -- come into the room and draw samples from the patient's arm, which they place in tubes in various colors, and keep the tubes in a nice carrying basket that you could buy almost anywhere. Each tube gets a name and a bar code label, so as not to get blood samples mixed up.

But today I stopped by the lab to learn further -- they put the blood into a machine that spins and separates the components, and then into another machine that measures electrolytes, for example -- the sodium and potassium levels -- or another machine that does a CBC, a Complete Blood Count. This link to Wikipedia explains that.

I like Wikipedia for explaining medical terms. I read medical journals at the hospital's library. The articles are often very dense, but I stop to look up terms on Wikipedia and then keep going.

The blood words are some of my favorites -- erythrocytes, leukocytes, basinophils, macrophages, and the always popular hemoglobin -- that's beginner's stuff. Blood is complicated, and every single component can go wrong, and get you out of whack and very sick. That's why they do so much testing at the hospital.

The other thing about blood that is a marvel to me is its source -- red blood cells are produced in the bone marrow -- but why? You would think there might be some kind of sack near your liver that pumped out red blood cells on demand -- but why does blood come from bones?

There is some production of red blood cells in the spleen, as a back up source. The spleen weighs about five ounces and it's tucked up high and behind your stomach. Spleens don't seem to do very much for taking up all that room. You can have your spleen removed entirely and it won't kill you, although you will need some medical adjustment. You wonder why we even have a spleen.

That's as much medical news as most people want, so let's do the politics, specifically Barak Obama and his church and his pastor. I've heard so much discussion about this but nobody seems to include Mrs. Obama in the speculation.

The Obamas have a very good marriage of more than twenty years, and two young daughters. The evidence for that is that we don't know much about it -- the vigilant press corps would instantly exploit the minutest difference or disagreement between these two, but you couldn't slip a piece of paper between Michelle and Barak -- they are united in purpose and it looks like love to me. And they have kept their private life private, which is a blessing to themselves and to the American voter.

It is a faithful union. Michelle is a very good-looking woman. On top of that, she's dangerous when she's mad. For those reasons, there is no way that Barak is going to be chasing interns around the Oval Office. He will be coming home every night, because he has a very good home to come home to.

Michelle has been left out of the pastor flap. But don't you think it was her idea to join that church 20 years ago? It fits her persona, not his. Barak is not a religious man -- not like Jimmy Carter who taught Sunday school. Barak is more like many men who settle down with a good wife in a good neighborhood and go to church every Sunday because it's a good thing to do.

Rush and the right wing radio rodeo have been riding him hard on the pastor thing. But it still comes down to guilt by association, as Jack Kemp said to Sean Hannity today. If we judge Obama, let it be for his own words and his own deeds.

I just wish the Clintons would go away. I turned against the Clintons in 1996, so I have been steady on this -- nor am I recruiting people to join my animus. You all can make up your own minds.

My friend Bob says he misses John Edwards. Edwards represented a fairly standard progressive program, and a style that was combative but friendly. I think he would have been the best to represent that point of view -- with the least personal baggage, I mean. Edwards had the very big house and the $400 haircut going against him, but otherwise -- I mean, everybody has something.

The Invisible Man in this campaign season is George Bush. The Republicans NEVER mention his name, and that silence is very expressive.

I do advise all Frog Hospital readers to pace yourselves in this long campaign year. The Obamas are spending the Easter weekend in a tropical hideaway, and I hope they are not discussing politics.

Happy Easter,

Saturday, March 15, 2008

Health Care issues

People keep asking me about the election -- so much has been going on since Hillary and Obama had a dead heat in the Texas and Ohio primaries. Mostly it's been a lot of noise and not worth mentioning.

The same with Gov. Eliot Spitzer's fall from grace. He had a problem, he resigned, and that's all there is to it. I enjoy reading titillating material, but I have other sources for that.

Elected officials should resign whenever their personal lives intrude on their public service -- even if they are innocent. I believe in the abundance of talent -- meaning we can all be replaced, meaning that no governor or president is uniquely qualified to hold the job -- there are plenty of people waiting in the wings who are just as good.

That argues strongly against the Clintons -- their personal lives grossly intruded on the public space in 1998 during the Monica Lewinsky scandal. They should have resigned. Al Gore could have taken over and served as well as the Clintons.

But I give Hillary credit for being co-President back then -- which is why I don't support her now. The Clintons had their 8 years. Nobody gets to move back into the White House. As for Bill, he should remember that ex-Presidents should be seen and not heard. He needs a life -- I suggest fly fishing.

Now comes the tape-recorded rantings of the gravel-voiced preacher from the South Side of Chicago. People are shocked that Barak Obama sat in this man's church for 20 years, but that's how some preachers talk in that part of town. It's nothing new -- not to anybody who has spent time on the South Side -- this is a uniquely American neighborhood, a rich proving ground for Obama's talent. Talk about a "lifetime of experience," one summer on the South Side is worth a lifetime in the suburbs.

And Old John McCain is spending the weekend in Iraq -- his 8th trip. He knows the territory well and he's staking his campaign on victory. He might choose Mitt Romney as his VP. That will give McCain some economic heft, but what excites me is getting Condaleeza Rice on the ticket. Now there's a woman! Let's get Condi in a debate with Hillary -- brains? stamina? fighting spirit? Who wins that one?

Okay, that's a roundup of the current nonsense, so let's talk about Health Care. Hillary and Obama propose that the federal government supply health insurance to over 40 million uninsured Americans. Further debate between them over the details are pointless. The real debate is with McCain, and it gets down to who is going to pay for it. McCain advocates free market solutions, he also advocates state-by-state remedies.

One hopes for a serious argument about this.

All I have to say about this is that the lack of insurance is not the only health care problem in America. Here's a few more:

The nursing shortage: Doctors are wonderful people -- they diagnose, they make decisions, and they give directions. But it's nurses who do the work. Nurses are the heart,soul, and muscle of health care -- and more than half the brains, if you ask me. But, got to the website of any hospital in the country and click the link on "career opportunities." You will find dozens of unfilled RN positions. That means short-staffing. That means over-worked, tired nurses looking after your mother.

Of course, when we get Hillary or Barak's national health care plan in place, that will solve the problem. But what is this? They have a nursing shortage in Canada and in England, too.

The nursing shortage is caused by increased career opportunities for women -- a growing problem in the developed world. Nursing is a hard job, and there are easier ways to make a living. A massive pay raise might work, or else we kidnap every available woman in the Phillipines and bring them over here.

An epidemic of childhood diseases. A rising rate of childhood asthma, childhood diabetes, and childhood obesity. This is very perplexing. Why is this happening? How can it be prevented? There's a lot of wild guesses of about complex environmental causes for these diseases, but honest people should admit to being stumped. This should not be happening in our ever-so-prosperous country. But Hillary doesn't have the solution, neither does Barak or old John.

Too many old people. I'm referring to myself and my generational cohorts. You think we have a nursing shortage now? But new hordes are coming down the health care pipeline -- a generation slipping into their dotage and still sadly called "Baby Boomers."

And just one more, malpractice. It's really nuts. What do lawyers know about medicine? I never go to see a lawyer when I'm sick, I prefer going to a doctor. Of course, doctors should face consequences for their errors, and be accountable to the public for their negligence, but there has to be a better way.

That's all I have to say. On a personal note, I had a wonderful time visiting my daughter in Texas and catching the election. Just a bit of sunshine makes all the difference. I am back to work full-time at the local hospital, where I have been employed since last autumn. I also expect to do a bit of landscaping for my regular customers this spring.

All, the best, and God bless America,

Tuesday, March 11, 2008

Today's Medical Fact

Today's very important medical fact is that you can wear a hat in bed -- almost any kind of hat, except, possibly, a very broad-brimmed hat which might get crushed in the back. Still, you could wear a cowboy hat in bed, if you were a cowboy or wanted to be like one, or a frilly ladies hat with feathers.

I am mentioning hats, as possible, because at this hospital where I work -- you WILL get into out standard hospital gown, with your butt hanging out in the breeeze. You will not be wearing street clothes, nor shoes, nor pants, nor a belt, or a shirt or a blouse or a dress -- none of that.

But you can wear a hat.

Saturday, March 08, 2008

Brooke Army Medical Center

Brook Army Medical Center (BAMC) is a Level I Trauma Center at Fort Sam Houston, just outside of San Antonio, Texas.

If you are unlucky enough to mangle your body in a car wreck, you could at least plan to do that in the San Antonio area. They have three Level I Trauma Centers -- BAMC, Wilford Hall Medical Center at Lackland Air Force Base, and the University of Texas Medical Center.

Seattle, with a larger overall population, has one Level I Trauma Center at Harborview in down town Seattle. Harborview is owned by King County, and managed as a teaching hospital by the University of Washington. All staff are university employees, all physicians are medical school faculty.

Level I Trauma means they have a team of surgeons, burn specialists and so forth on site 24 hours a day.

Nobody knows Anything

--written on the eve of the Texas primary--

I made it down to Texas to look at the primary. I've been in Austin the past few days. The excitement in the air is electric. I have spoken to Obama's people -- they're having so much fun, they think they're winning. I have spoken to Hillary's people -- they are steadfast, determined and conceding nothing.

It's really all about the Democrats this week and how much Texans love the attention. Famously insecure, the flipside of their bragging nature, Texans need to know that we all love them. They need to know we think they are important. So I speak for many in saying this: "Texas, we love you, you are very important, and we wait breathlessly for your decision."

Ohioans -- they 're important too, of course, but their nature is self-deprecating. They don't need love and attention -- they just want jobs.

Okay, Hillary -- this is bad luck -- moved her state headquarters office into an empty building on Ben White Blvd on the south side of town, but what all the locals know is that Kinky Friedman, the ridiculous candidate for Texas Governor, used that same building in 2006. Really bad Ju-ju for Hillary.

Obama, in contrast, took up space on the second floor of a bank building for his state headquarters. I paid seven dollars to park my car nearby, just so I could drop in to visit. A media relations guy came out from a warren of back offices and blew me off in two minutes. I wasn't important enough to get his attention -- not representing any big media, not representing any newspaper that he had heard of. Unfair of me, but I marked down Obama's people for Failure to Greet.

Meanwhile Hillary is getting slammed by Maureen Dowd and the whole staff of the NY Times -- Dowd's column is her own opinion, but the highly dubious "analysis" stories on the front page, stating that Hillary hasn't got a chance, and making all kinds of unfounded characterizations about her -- it's kind of weird. There's a place for subjective impressions, but it's not news. I figure they got Obama hype despite themselves, but it's not fair to Hillary.

Also, it's not Obama's fault. He gets better all the time and he is too smart to believe all that Obama hype himself. I heard him at a rally in Austin on Thursday morning. First he gave his standrad stump speech -- I've heard it before. But then he fielded questions from the crowd, getting hit with a wide variety of challenges, and he handled them well -- giving substantive answers and responding to that criticism.

Tom Brokaw came to Austin last week to do a segment on the youth vote, which leans heavily toward Obama, especially in Austin. This is true -- the kids are out it in force -- but pardon me for not getting excited when I hear a 24-year-old graduate student gushing, "I'm going to vote! I'm even going to make phone calls!" Am I supposed to be impressed? Big whoop.

"Nobody Knows Anything." Nobody knows who is going to win the primary on Tuesday, and they are so deeply certain that they don't know that they won't even make a guess. We're all just sitting here -- those of us who aren't madly campaigning and doorbelling -- sitting here with our mouths open, saying dumb things like, "Gee, isn't this something?"

The Republicans were feeling lonely, so I stopped by their state headquarters and visited with the executive director of the party. He said they like their man, McCain, and they'll take their chances. Rush Limbaugh's kinky ploy to get Republicans to vote for Hillary in order to stop Obama -- that one died. The New York Times published second-rate innuendo about McCain's love-life --- give us a photo with the babe sitting on McCain's lap, otherwise shut up. The last bit of GOP news is how excited they get thinking about getting Condaleeza Rice to take the VP slot. Of course, she doesn't want the nomination -- but if they get her on the ticket, with her reputation and her magic two-fer qualities -- I can see her challenging Obama, "Hey, Barak, your mamma's ugly and you're dog can't fight!"

But that's all the Republican news.

So we will all know in 48 hours, but right now, "Nobody Knows Anything."

What a country -- I love this election.