Thursday, July 23, 2009

Prayer request and travel plans

This seems to be happening all too often these days, but for anyone who's reading this, I'd really appreciate your prayers for one of my good friends from college and her family. Her mom is really sick, and not for the first time; it gets harder and harder on my friend and her entire family each time her mom ends up back in the hospital. If anyone could use prayers right now, it'd be them.

Second and less importantly, tomorrow morning I'll be off to Phoenix for a little over a week, followed by a week in Providence. I still don't have a camera so I can't promise pictures of the trip, but I'll try. I'll be back in da 'Burgh on August 10, just in time to help out with orientation for the new 1st years. I'm not sure what kind of internet access I'll have in Phoenix, so I may not receive emails till I'm back in Providence.

Anyhow, I'm signing off for now. Gotta eat, finish packing, and then get to bed...early flight tomorrow.

Peace and God bless!

Wednesday, July 22, 2009

Health care reform, part I

I've spent some time over the last couple of days looking at the House of Representatives proposal regarding health care reform. Of course, the bill is over 1,000 pages long, so I've only seen a very small part of it. Thus, this will probably be an ongoing (and sporadic) series of posts as I read more. I should say at the outset that I am wary of this plan, but I'm not about to dismiss it out of hand. I plan to frame this as a series of questions, and I will attempt to point out both the good and the bad in the plan. As always, [polite] commentary is appreciated.

One of the overarching questions that I think needs to be addressed: who is eligible for health insurance under this plan? Will, for example, illegal immigrants be able to receive health care under the so-called public option? (I think it's important to note here that I don't think this is necessarily a good or a bad thing; it's all in the context).

Another thing that needs to be addressed: part of the reason that health care reform is necessary in the first place is because of the ballooning costs to which Mr. Obama alluded in his remarks this evening. An enormous part of this cost is derived from the fact that physicians are virtually required to practice defensive medicine rather than being permitted to rely on their best judgment. If you take a blow on the head, unless the doc is 100% certain that there is NO risk whatsoever, you're likely to get a CT, over 99.9% of which will be negative. Why? Because of the threat of lawsuits for enormous amounts of money. Of course, not even doing everything right eliminates the risk. One woman threatened to sue any physician who 'let her father die.' The man was over 80 years old, everything in his body was falling apart, and he was kept alive and coded multiple times (very expensive and horrid quality of life) because the physicians were laboring under the threat of a lawsuit. Of course, they couldn't keep him alive indefinitely, and when at last he died, his daughter did in fact sue. The kicker? The insurance company settled for thousands of dollars rather than undertaking the "nuisance" of defending the physician's reputation and actions in court. We are a litigation-happy society, and that inflates malpractice insurance, requires physicians to order expensive and unnecessary tests and procedures, and drives health care costs through the roof.

A brief interlude here: Mr. Obama is certainly well-intentioned, but in terms of actual health care, he clearly knows not of what he speaks. He's right that we need better communication, but he seems to be laboring under the delusion that there's a single "correct" diagnosis or test for every patient, and that docs should always be able to arrive at the right conclusions. While I appreciate the confidence, that's not the way it works. There's a reason we have different kinds of specialists and different kinds of tests. He's also very deft at playing politics while appearing to take the high road. I know that's ubiquitous in Washington, but it's kind of disappointing in someone who's been portrayed as being above that. I will reiterate, however, that I DO believe that Mr. Obama is genuinely doing his best for the American people, and I agree with his assessment that he was given an absolute mess to begin with.

Another thing I want to comment on is the concept of exclusions for pre-existing conditions. In some ways, these are reasonable protections for insurance companies against fraud. That said, they can easily be abused, and the exclusion periods seem excessive. Certainly they do not appear tenable in their current form; however, is it financially feasible to eliminate the exclusion altogether? It seems like that's the kind of thing that unscrupulous people (and there's no shortage of those in America) could easily take advantage of. How can this be crafted to strike an appropriate balance?

Another interlude: props to Mr. Obama for this one. I completely agree that it should be the physician rather than the insurance company deciding what care is appropriate. Of course, the question of reimbursement becomes a sticky one, but still, the thought is right on the money.

Ok, that's it for now. I'm going to finish listening to this press conference and maybe do some more reading. Any thoughts or commentary would be most welcome!

Peace and God bless!

On Ordinary Time

Some brief thoughts on the season of Ordinary Time:

Despite the fact that there's no big holiday associated with it, there's nothing "ordinary" about it. Nor is it merely marking time while we wait for Advent to begin or Easter to arrive or some such. Ordinary Time is a remarkable and beautiful season in its own right, and in some ways it is perhaps the most sublime liturgical season of all.

During Advent and Lent we prepare ourselves for the celebrations of Christmas and Easter. We celebrate the great mysteries that define our faith: the Incarnation, the Crucifixion, and the Resurrection. We celebrate the greatness of God as it is made manifest in those mysteries. But in Ordinary Time, we celebrate the greatness of God because He is God. We need no other reason.

It is indeed a time to focus on the ordinary, on things to which we would normally not give a second thought. When we begin to contemplate the ordinary, we quickly arrive at the realization that there is nothing "ordinary" about it. The simplest things -- a daisy, a robin, the smile of a person that you see every day -- they are all, in their way, exquisite. They are all ordinary, yet they are all extraordinary. They are all the gifts of God's wisdom and grace. They can all be powerful and awe-inspiring reminders of the majesty and the unbounded love of Father, Son and Holy Spirit.

So take a moment today to think about something ordinary. On closer inspection, you may just find that it's not so commonplace after all. For sometimes the most routine things -- like Ordinary Time -- may just be the most extraordinary.

Peace and God bless!

Saturday, July 18, 2009

Working with kids

A few things for today:

First, please continue to keep my friend and her family in your prayers.

Second, I wanted to say a few words about the tenth and eleventh graders that I worked with this past Wednesday. I have to say, it sounded like a pretty tough schedule. Many of them were coming from an hour or two away and so were only getting four or five hours of sleep. Needless to say, these teenagers weren't too excited about having what amounted to a series of 20-minute lectures first thing in the morning. I was assigned, along with one of my fellow MS-2's, to present a synopsis of the neurological exam. Fair enough, we figured, we'd do brief presentations on cranial nerves, cerebellar testing, and then demonstrate reflexes and let them practice on each other. Well, never having done it before, the first group was a pretty fair disaster. I'm pretty sure at least two of the kids fell asleep. So we picked it up for the second group, had plenty of time to do our "fun" activity (reflex testing)...and found out that they had already learned how to do this the previous day. Oops. Sooo, we started improvising. We starting doing things like demonstrating Weber and Rinne testing, pupillary reflexes, and the Babinski sign. (After much debate, we decided to skip actually showing them how to test a gag reflex...) It ended up going ok, although it was pretty evident the kids had had about enough after three or four stations (I think there were seven total).

The afternoon got everyone much more engaged. They were presented with a public health crisis - they had to come up with a plan for dealing with an H1N1 / H5N1 flu outbreak in Pittsburgh. The discussion was very spirited and HIGHLY entertaining. As the scenario got more complicated (oh, it seems that the disease has spread to DC) and the kids had more and more to deal with, they became more and more desperate...and increasingly hilarious. I didn't know whether to be amused or disturbed by the frequent references to "I Am Legend" and when we suggested that there were really no wrong answers, we had to retract almost immediately thanks to a "cut your losses...nuke the city" suggestion. In the end, the kids decided to quarantine a radius of 40 miles around the city, make all the citizens remain in their houses under guard (military and police who would be supplied with protective gear), to set up triage stations at Mellon Arena, and to supply the city by airdrop (all supplies would be dropped into Heinz Field). We tried to indicate that this would require far more in the way of manpower, money, and supplies than we would have available, but to no avail. Still, it was certainly not a terrible plan and it was very interesting to see how they prioritized -- they emphasized the good of the community over individual freedom and suggested eminently pragmatic and unsentimental measures. There was even some suggestion that the media should be asked to lie to prevent panic, although this was eventually voted down on the theory that offering misinformation would cause greater panic than truth ever could. The group dynamic was also interesting -- one girl established herself as the clear leader, while the others each had at least one substantive commentary on some issue about which they felt strongly. It was fascinating and truly entertaining, although I almost died when they presented the "nuclear option" and the "day of the dead" option (kill all of the infected) before getting to their actual proposal in the big group setting. I'm kind of shocked that Dr. Gonzalez didn't ban us from all future related events...

Anyhow, that was a truly fun and rewarding experience. I don't know if I'll get any photos from that event, but if I do, I'll post them here.

Third, I do have some pictures from the Health Scholar's Academy that I and a handful of other PittMed students helped out with last week, so I figured I'd post those.













That's all for tonight; on tap for tomorrow (circumstances permitting): reflections on Ordinary Time. Till then, take care!
Peace and God bless!

Thursday, July 16, 2009

A prayer answered; a prayer asked

To anyone who prayed for my aunt, thank you; she delivered a healthy baby boy by C-section this morning (5 lb 7 oz, 19 in). They'll be in the hospital till at least Monday, but they both seem to be in terrific shape. Unfortunately, no pictures yet...maybe next week?

In other news, I was hoping today to spin some tales about my experiences teaching 10th and 11th graders yesterday at Scaife. Unfortunately, it appears that what you get instead is another prayer request. From the little information I have, all I can say for certain is that one of my friends here at school apparently suffered a family tragedy today. I don't know for sure what happened; all I know is that something bad happened. So please keep her and her family in your prayers.


Psalm 130 - De Profundis (From the depths)

Out of the depths I cry to You, O Lord
Lord, hear my voice!
Let Your ears be attentive to my voice in supplication.
If You, O Lord, should mark our guilt,
Lord, who would survive?
But with You is found forgiveness,
For this we revere You.

My soul is waiting on the Lord;
I count on His word.
My soul is longing for the Lord
More than the watchman for daybreak.
Let the watchman count on daybreak
And Israel on the Lord.
For with the Lord there is mercy,
And fullness of redemption.
Israel indeed He will redeem
From all its iniquity.

Eternal rest grant unto them, O Lord, and let perpetual light shine upon them.

Peace and God bless...

Wednesday, July 15, 2009

Prayer request

My aunt, who's about 35 weeks pregnant, is currently in the hospital with bleeding problems that apparently have the docs there baffled. She and my uncle have been bouncing back and forth between house and hospital for a week now without answers or any kind of solution to the problem, so I'd really appreciate any prayers you could offer for them and their child at this point. Thanks, all.

Peace and God bless!

Sunday, July 12, 2009

The eternal "now" of the love of Christ

This was the topic for Fr. David's homily today, and I thought it was worth some virtual ink. One of the easiest things in the world, as he mentioned, is to get caught up in the past, or to spend one's life "looking away to the future, to the horizon" (bonus points for identifying the movie quote -- it's a seriously easy one). When I think about it, it's really easy to see how true this is in my own life. How many times each day do I catch myself brooding about things that have already happened, wondering if maybe I shouldn't have said something or should have done something differently? How often do I relive old moments, fretting over that which I no longer have the least ability to change? And it's even easier to spend too much time looking forward in any of a number of ways. This is perhaps understandable -- the future is unknown to us, and so we come up with plans to make it seem less frightening, less overwhelming. So instead of accepting that we don't know, we design something of a fantasy life and try to convince ourselves that our vision reflects a future reality. But both of these things remove our focus from the present, from where we are now. (Side note - in his book The Screwtape Letters C.S. Lewis makes a very interesting argument regarding why concentrating on the future is an especially dangerous thing. I highly recommend it.)

But hold on a minute. This whole "living in the present" thing, isn't that what most people do nowadays? Isn't it the "Do what you want today because tomorrow may never come" mindset? Well, no. I think it's particularly important to make a distinction between "living in the present" vs. "living for the present." When we do the former, we are trying to allow the presence and love of Christ to affect us where we are. We recognize the day for the gift it is, and we open ourselves to the grace that God offers us. The latter is something entirely different. When we live for the present, we neglect God's grace entirely. This is the mentality so common today, the idea that it's perfectly acceptable to do whatever we feel like because today is the only thing that matters. In living for the day, the eternal is deemed to be of no consequence; indeed, the very concept of eternity is alien. It offers no recognition of past or future, which (it must be emphasized) is NOT true for one living in the present.

It's getting late and I'm becoming incoherent, but I want to take a moment to offer a quick summary of what I think it means to be living truly in the present. It means that, on some level, we have come to terms with the unalterable nature of the past and the uncertainty of the future, and that we are willing to commend the past to His mercy and the future to His grace and providence. It means that we open ourselves to His love now, that we seek Him where we are, and even when we can't seem to see Him, we still choose to open our hearts and obey His commands. It means acknowledging our own limitations and shortcomings, and placing ourselves in the hands of the One who has promised to be our shepherd. ...um, yeah, I can't do all that either. I'm not even close. What makes it so tough? Because as with so many things in life, the hardest part is letting go.

That sounds like a nice dramatic ending, and I don't have the energy to go into detail for the purposes of explanation just now, so we'll leave it there for the night.

Peace and God bless!

Thursday, July 9, 2009

Today

I had the chance today to work with some high school seniors who are in a high-intensity summer program. It was a lot of fun for me; I got to answer their questions and teach them how to throw sutures in pigs' feet. They seemed like they were having a good time, but there was something that really stood out to me. More than any other high schoolers I've ever met, they were tense, worried about the future, not convinced of their own adequacy. There were so many questions about what they needed to do, what they should study, how they were going to get into medical school. They were already filling their resumes with volunteering activities, with high-powered classes, and with all sorts of things designed specifically to get them into medical school. Even this program they're in, while the part that I participated in was fun, is an incredibly intense, demanding, difficult academic exercise. They have virtually no free time during the program, and it involves heavy classwork, at least one research paper, and the design and execution of a service project. Don't get me wrong, I think the program is a very worthwhile one; it's just that there is NO way you could have convinced me to spend my last summer in high school doing something like that.

Maybe I'm not the best person to judge; after all, the desire to become a physician is something that I've only come to relatively lately. It hasn't been a lifelong dream of mine to be a doctor, and for many of these guys, I think that going to medical school (PA school, nursing school. pharmacy school) has been their only dream all their lives. Still, it seems to me that as kids going into their last year of high school, they should be getting excited about college rather than fretting about medical school. As I said more than once today, you only get to do college once, and in my experience, there will always be part of you that wants to go back. Sure, it's important to work hard while you're there; after all, only a very small proportion of the population gets the opportunity in the first place. But college is also meant to be fun, a time to learn about yourself and to make the most of life. I feel like it's such a waste to make the college experience nothing but a springboard to medical school. They're all talking about what activities they need to participate in, what they need to major in, how much they need to study for the MCATs. In a lot of ways, that saddened me. My four years as an undergrad at PC (Providence College, just in case there's someone reading this that doesn't recognize the abbreviation) were perhaps the best of my life, and my experiences there played an enormous part in making me who I am now. But a big part of that change was that I became far less prone to sweating the small stuff. I began to focus on what was good in life and doing what I enjoyed, even while I was working hard on my studies in chemistry. I really don't think it would have been the same if I had been worrying about all the things these kids were worrying about. If they're stressing out this much now, before they even hit college, what's going to happen a couple of years from now when the work is much harder and lives may be riding on it?

Maybe I'm wrong, but it seems to me that there's enough stress in life to begin with. Is it really necessary to create more of it? Anyhow, those are my thoughts for the evening. Stay tuned...

Peace and God bless!

Friday, July 3, 2009

Home

Being home with my family allows many more opportunities for activities and ways in which to keep myself occupied than does living alone in Pittsburgh. Hence, since I've been doing other things, I haven't been updating this blog as frequently.

As awesome as Pittsburgh has been, there's simply nothing that beats being at home. I know that I'm never going to look back and wish that I'd spent less time with my family, only the reverse. So I'm going to enjoy it while I'm here. And as much as anything else, it's the little things that still give this a sense of being "home": grocery shopping with Mom (it's a little different shopping for a family of 7 -- effectively 8 -- than just buying what I need to get through the week), putting the air conditioners in and playing Rock Band with my siblings, and hanging out in the Hasbro ER with Dad. It's an experience that bears absolutely no relationship to my solitary living arrangements in Pittsburgh, and for that reason, it's always tough heading back to da 'Burgh after being at home. Everything seems quiet, monotonous even. When I get on the airplane, I always feel like I'm traveling in the wrong direction. But I always know that, God willing, I'll be here again with my family and all will be right with the world.

That's not to say I don't love you guys in Pittsburgh, but I have the sneaking suspicion that any of you who read this blog (all two of you) know exactly what I mean. Catch yinz back in da 'Burgh.

Peace and God bless!