Real Doctors

The ICU doctor posted his work record for the previous week on his facebook page, directing his post to many of his former residents and medical students, as an example of how recent rules limiting their work hours to 80 hours a week was not preparing them for 'real' life. Somewhat proudly his record revealed he had worked 102 hours that last week as a locums doctor at an outside facility from his usual academic job. The tone of his note was one of disdain for these new rules and a wake up call for these young doctors. 'Real doctors' work long and hard.

I would argue it is the fine doctor that needs the wake-up call. Most of the time the ONLY reason doctors work such extreme hours is money, not for the doctor but for shareholders and administrators. Better to pay one doctor overtime than hire one or two more doctors to more properly cover the shifts. Better only for the bottom line. He is being taken advantaged of to the determent of patient care, the staff, his family, himself - all solely to enhance administrative bonuses and bottom lines. It is not heroic to allow this to happen to oneself - it's dumb. 'Real doctors' I would argue are rested, sharp, and always on their game - with balanced lives and happy spouses and children - and are not working 100 plus hours a week.

There are communities that do in fact experience real physician shortages, requiring local docs to to step up and attempt to cover real need. But in this day and age of easily accessible locums doctors as a stop gap measure until real recruiting effort is fruitful - even these areas are suspect. More often than not medical organizations are simply unwilling to pay for temporary doctors and are slow to recruit due to monetary concerns - in effect taking advantage of the local doctors who often confuse being used by business people as an altruistic call to duty - 'real doctors' work long and hard.

This is not in our society's best interest. It's not in the interest of good patient care. And it's a lousy example for our up and coming physicians. Doctors need to get over themselves, stop wearing 100 hour work weeks as badges of honor and grow up. 'Real doctors' know how and when to say enough.

Intelligence Won't Need Spacecraft

Do I believe in UFOs?
Do I believe there are unidentified flying objects in the sky - yes.
Do I 'believe' they are the craft of alien civilizations come visiting?

Well...How likely is that?
The universe is a big place. Earth a tiny spec in a massive sea of nothingness.
Just statistically - the odds of aliens coming to this planet - pretty slim.

If you are asking is the universe teeming with intelligent life? - then the answer is - almost certainly. If you are asking if this intelligent life will climb into spacecraft capable of flying distances within our galaxy, and come pay us a visit? - then the answer is almost certainly no. In fact the chances of that happening are almost non-existent. But not for the reasons one may think.

The answer to this I think is way cooler than alien craft being our UFO's - and much more likely.

Technological growth is exponential. What seems to be linear growth for many, many years suddenly begins to curve upwards approaching infinite growth over very small periods of time. The processing power of computers - one example.

The invention of the computer is inevitable with any intelligence capable of spaceflight and/or communication using electromagnetic radiation - radio. The growth of its capabilities - exponential. Within 100-200 years of the invention of the first computer - and before any attempts at intergalactic travel - the computer will evolve into a super computer and greater than creator artificial intelligence will evolve.  AI growth is itself exponential and it will evolve into super intelligence in very short order. The creation of an intelligence millions, if not billions of times greater than its creator, is then the fate of all intelligent species capable of spaceflight - provided they don't destroy themselves first.

A billion order greater intelligence would be indistinguishable from god, and would provide avenues of existence outside the biologic, perhaps outside of this universe.

When this happens, and it will happen, intelligence won't need spacecraft.

Make America Better II

Donald Trump's campaign slogan: Make America Great Again. Does that mean we're not great now? Well then when were we great?

Are we referring to the 1950's and 1960's ? A time of the greatest expansion of the middle class in our history. When made in America meant made in America and that meant quality. A time when we led the world in the space race and landed men on the moon. A time when the American dream thrived. But wasn't that the era of the greatest socialist experiment in US history? The GI bill. The establishment of the Veterans Administration, social security, medicare, NASA, the US freeway system?

Well if not then, when? The era of Ronald Reagan? A time when our president negotiated hostage release by illegally selling weapons to Iran, our enemy? A time that saw the tradition of huge government deficits begin. Ronald Reagan increased the national debt by $1.86 trillion – nearly twice what his eight predecessors did combined - in large part through tax cuts to the wealthy, and despite massive cuts to social programs. As just one example, mental health funding was slashed resulting in a massive exodus of the severely mentally ill out of hospitals to the streets - all the while racking up huge debt while he funded the wealthy with his tricle down economics. We now know what was trickling down and it wasnt prosperity for the poor and middle class, quite the contrary.

Make America Great Again? America is great, right now. But it can always get better. Let’s stop living some childish fantasy about bygone eras that never existed. Instead, tells us Mr. Trump: How Exactly Are We Going to Make America Better?

Telemedicine From 50 Feet Away

You can spot medical residents in training a mile away these days.
They all have flat asses and stage three decubitus skin ulcers.

Computers, physician order entry, and the worlds first digital generation- oh my.

Tucked away in their offices 50 feet off the hospital units - never to be seen.
Frequently making it through their month rotation without the nurses ever putting faces with names, sitting on their asses at their computer screens to the point of skin breakdown.

Coddled and anonymous they graduate from academic computers to private ones - grossly inadequately trained, unless of course the goal is to kill people.

It used to be academics attracted the clinically inept that somehow managed to adequately train those who went out into the world and got real jobs. Now they can't even get that right. The average academic will go to great lengths to avoid actually touching patients - emotionally or physically. That example is now only to easy to emulate using digital media, and an entitled attitude. Add in a coddled, litigious generation and we've got the perfect storm.

Time to figure out how to incorporate the digital age into medical care while producing quality doctors. The arcane obsolete model that is academic medicine needs to go.

Ghostly Temples of Doom

In medieval Europe, Japan, China great palaces, castles and massive places of worship were constructed. Designed to awe and intimidate as much as serve a function these buildings were self perpetuating temples of power and wealth.

Today it is the sky scrapper. Temples of profit, influence, wealth, greed.

Somewhere along the line the western world has confused corporatism for capitalism and capitalism as a building block of democracy. Obsessed with profit and the accumulation of wealth, corporations use these massive temples to define our cities, our culture, our very way of life. Profit our mantra, greed our guidepost, wealth and accumulation of stuff our purpose in life.

Corporations exist for one fundamental reason and one reason alone - profit. Human suffering, the health of the planet, compassion, empathy, love, and at times even the preservation of quality human life be dammed - profit.  Their sky scrappers massive temples of steel and glass, stupidity and greed - and eventually ghostly temples of our doom.

This is not sustainable. This is not healthy. We are a sick society. Profit is a false god, these temples symbolizing so much of what is wrong in our lives, our spirituality, our purposes.

The Planet Doesn't Need Saving - We Do

Well we’ve certainly made a mess of things.

Jihad, global warming, mass extinctions, Donald Trump, widespread poverty, disease, unstable world financial markets, Donald Trump.

Our infrastructure, our very existence, is exquisitely vulnerable to self made and existential threat - emotional isolationism, worldwide conflict, solar mass ejections, massive asteroids, heated up supercharged weather, drought, worldwide crop failure, volcanism, and yes, Donald Trump.

The environmentalists tells us we must save the world.

The conservatives tell us we must conquer the world.

The wealthy tell us we must use the world – up.

Donald Trump tells us he is the world.

Ha! They’re all wrong! And George Carlin was right.

We can't do the world any lasting harm - the earth has been around for 5 billion years and seen much worse than us. At the rate we're going it's only a matter of time until it wipes itself clean of us and just keeps on keeping on as it always has - with us becoming the tiniest of tiny footnotes in its long history.

We can continue to delude ourselves into thinking we must save the world, or the world is for conquest, or ‘wealth’, or a playing field for egocentric nonsense. Save the world? The world doesn’t need saving folks. We do.

Intellectually, ethically, spiritually we must fundamentally change or we aren't going to make it.

Either way the world will be just fine. 

Is Donald Trump a Socialist?

Donald Trump's campaign slogan:
Make America Great Again.

Make America Great Again
What does that mean Mr. Trump?

Does that mean we're not great now?
Ok, so when were we great?

Are we referring to the 1950's and 1960's - the era of Leave it to Beaver, Father Knows Best?
A time of the greatest expansion of the middle class in our history.
When made in America meant made in America and that meant quality.
A time of peace and prosperity and great hope.
When we led the world in the space race and landed men on the moon?
A time when the American dream thrived?
But wait - wasn't that the era of the greatest socialist experiment in US history.
The GI bill. The establishment of the Veterans Administration, social security, Medicare, NASA, the US freeway system, civil rights reform.

Make America Better

Donald Trump's campaign slogan:
Make America Great Again.

Make America Great Again
What does that mean Mr. Trump?

Does that mean we're not great now?
Ok, so when were we great?

Are we referring to the 1950's and 1960's - the era of Leave it to Beaver, Father Knows Best? A time of the greatest expansion of the middle class in our history. When made in America meant made in America and that meant quality. A time of peace and prosperity and great hope. When we led the world in the space race and landed men on the moon? A time when the American dream thrived? But wait - wasn't that the era of the greatest socialist experiment in US history. The GI bill. The establishment of the Veterans Administration, social security, Medicare, NASA, the US freeway system, civil rights reform? No?

Oh ok, then the Nixon years? Ummm no?

Wait, wait - Ronald Reagan. Ahhh yes - Ronnie and the good old days. A time of the worst recession in US history up until that time - only beaten out by the great recession of George Bush's era some years later.

A time of self indulgence, cocaine, discos.

A time when our president negotiated hostage release by illegally selling weapons to Iran, our enemy, using the proceeds to fund anti-Sandinistas in Nicaragua - even after congress had declared doing so illegal, even after it was clear these people were raping nuns and committing atrocities.

A time where tax cuts to the wealthy and military expenditures were in part designed to shrink government while asking the poor and middle class to pay for it all.

A time that saw the proud tradition of huge government deficits begin. Ronald Reagan's eight predecessors increased the national debt by a total of $975 billion. Reagan wound up increasing the debt by more than Franklin Roosevelt, Harry Truman, Dwight Eisenhower, John Kennedy, Lyndon Johnson, Richard Nixon, Gerald Ford and Jimmy Carter combined, adding $1.86 trillion despite massive cuts to social programs in the face of tax cuts to the wealthy. The beginning of a fine tradition.

A time of defunding of mental health and the subsequent massive migration of the mentally ill of this country into the streets. Homelessness of those incapable of caring for themselves increased dramatically as a direct result of Ronald Reagan's policies. Ah yes - America "a shining city on a hill," the beacon for the rest of the world - a hill covered with homeless people incapable of caring for themselves.

I've got news for Donald Trump and all the rest. America is great, right now. But it can always get better. Lets stop living some childish fantasy about bygone eras that never existed. Instead, tells us Mr Trump and all the rest of you politicians aspiring for the presidency:

How Exactly Are We Going to Make it Better?

The Flim Flam Man - Donald Trump

Trump supporters hate the Republican leadership.
So do I.

Trump supporters are tired of the same old corrupt, do nothing attitude, coming out of Washington.
So am I.

Trump supporters are ignorant.
We're all ignorant.

Trump supporters confuse being manipulated by a scam artist and narcissist who uses crude, 'direct', ramble-speak to dazzle and woo and to turn fear and frustration into hate and intolerance - for real change.  

I just knew there had to be a difference.

Karma and the Republican Leadership

Undaunted by the embarrassment and fiasco that was Sarah Palin as a vice presidential candidate, the Republican party pushes to ever lower and lower depths.
Donald Trump and Ted Cruz the best they have to offer.
Ha!

Obama is right. All of this election cycle is karma for the way the republican party has behaved these last 16 years. There was a country to govern in those years - not just unpaid for wars to fight, presidential and congressional elections to win. The people in this country had real honest to goodness needs - that had nothing to do with the single minded need of the republican 'leadership' to transfer wealth and later their stated number one goal - to destroy Obama.

Very real crises have befallen this country while the republican leadership attempted the greatest transfer of wealth from the masses to the very, very few through perpetual war, the privatization of the social net, non-competitive bidding with big Pharma and the 'defense' industry, and the deregulation of a corrupt wall street and banking system - all the while sticking it to the poor and middle class.

Karma baby.

Personally, I hope they choke on it.