Still Love Modern Medicine

In my last post I wrote about the being invisible to medical people who are focused on their technology.  But yet again I have reasons to be a wildly happy fan of modern medicine.  The visit that led to same-day laser surgery was a follow up from a routine eye exam.  In that first exam, the doctor doing the eye exam caught a blood vessel problem in my eye that someone else might have missed.  The specialist I went to for the follow-up visit said several times that Dr. Wenxin Wei is very good.

After the the dye in my arm and many strange pictures of my eye, it turned out I had fluid in my eye and a build-up of fluid can lead to vision problems including blindness.  So far, they don't know what caused it so I will be getting more needles in my arm to figure out exactly what is wrong.  The specialist, Dr. Roy Brod, (whom Dr. Wei said is the best in the area) said they may not find a cause.  But in two months he will do laser surgery on the other eye so both are repaired.  

In previous posts I have written about the many ways I could have been dead or crippled without modern medicine.  This makes twice I avoided blindness.  

And that is just what makes the healthcare debate so difficult.  I owe my life and sight to expensive, innovative treatments that did not exist when I was a kid.  Without those treatment I would be blind, dead, crippled, or maybe all three.  With them, we all have to pay more and more for health care.  In principle cutting big-ticket healthcare seems like a good idea.  But facing blindness or paralysis, I think healthcare costs look very reasonable.

Being an Invisible Patient

On Tuesday I had an appointment with an eye doctor.  It was a follow-up appointment from a routine eye exam in December that found some blood in my eye.  The appointment was almost five hours long and ended with laser surgery and me leaving wear an eye patch.

Too bad it was not Talk Like a Pirate Day.

At one point in the exam, a technician put a yellow dye IV in my arm and took digital photos of my yellowed eyeball.  She had another technician with her.  The second tech was in training.  The two of them were looking at the array of eyeball photos on a large monitor.  In one of them they found the problem and were delighted.  They pointed at the problem and said how interesting it was and the direction of blood vessels and other fascinating details.

I was sitting five feet away.  By the way, I rode 20 miles before the appointment and was wearing spandex bike clothes.

Then they started discussing what would cause the problem they saw.  In their diagnosis protocol, the usual cause for the symptoms they saw was high blood pressure or diabetes.

One said, "He must be out of shape.  Look at that.  Probably high blood pressure."

My rest pulse is 58.  My blood pressure is 120 over 70.  I do not have diabetes.  But they were excited by the images on the screen.  So I had to have high blood pressure and/or diabetes, even if I didn't.

At this point I interrupted and said I didn't have high blood pressure or diabetes and that I am not in bad shape for my age.  Maybe something else could cause my problem?

Then they asked if I felt I had low energy lately or was feeling lethargic.  So I told them I ran five miles and did 75 pushups with my sons the previous evening.  I went to the gym for 45 minutes that morning and rode 20 miles to the appointment.

They decided I was not lethargic.

Later the doctor came in, said they were going to correct the problem in the left eye that day and the right eye two months later.  Sometimes they never find a cause.  He ordered blood tests to rule out infections.

I understand that people with complex jobs have to rely on protocols to interpret the vast amounts of data they deal with.  But it still is a strange experience to be discussed like a piece of meat.  Or an eyeball!

"Chill out will ya"

Ok.  Last post I was talking about my very noble friend who faced a choice between family and his comrades.  And I talked about choosing between two good things.  That was on the train going to work.  Now I am on the train home in the quiet car.  I sat next to a guy who seemed pissed off to share the seat.  Ten minutes after we leave the station, he takes a call.  I let him know we are in the quiet car.  His response is to say "Chill out will ya" and stomp away out of the car.

Which means, he is among the small but constant group of people who sit in the quiet car so they won't have to listen to other people's calls.  What they want is the "Quiet Except for ME Car."

As opposed to the person choosing between two good things and doing the right thing, these people--the ones who know very well they are sitting in the quiet car--want the world to revolve around them.  They have every opportunity to choose to do the right thing and choose to be jerks instead.

The Four Loves in Camo

No, I am not going to write about a soldier with four girlfriends (or she could have four boyfriends!).  CS Lewis wrote a book called The Four Loves about the four Greek words for love.  We lump all these words together in our one word Love.

In Greek the word Eros is romantic love, Philia is friendship, Storge is love among family members and long-time familiarity, and Agape is what we call charity.

Yesterday at lunch I talked to a soldier who volunteered for an upcoming deployment, then changed his mind when it looked like his marriage would end when the wheels went up.  His one-sentence choice was between deploying with his buddies or keeping his family.  He chose his family.

But The Four Loves makes clear why this is no easy choice.  Friendship and Romance are different kinds of love, but they are both love.  And both Friendship and Romance grow from a free choice we make of that particular friend or lover.  Of all soldiers we serve with, there are a few whose company we enjoy above all others.  Falling in love often begins with a moment in which we see our beloved and decide in a moment 'That's the one.'

Which puts Romance and Friendship in stark contrast with Charity and Family.  We do not choose our uncles, cousins, in-laws, children and even pets.  Families form from existing families, blending and adding to form a new family.

Charity is expressed best by God's Love for us and Mother Teresa's love for lepers.  God accepts us as we are:  needy, nasty, selfish and small.  Loving us does not show His good taste, but His compassion.  When Mother Teresa lifted a leper from a Calcutta gutter, she was not thinking 'This is the best leper in this gutter.'  She was expressing the kind of Love God has for us and wants us to have for others.

While  Romance and Friendship are a free choice based on our estimate of the value of the beloved, Charity and Family Love are freely given with no regard to value at all.  We love the child who didn't learn to tie her shoes till she was 12 just as much as the one who is on the honor roll and a starter on the soccer team.

All through my Army career, I have seen these agonized choices between two good things.  A man who is choosing between family and friends is torn by two kinds of love.  The toughest moral choices are not between Good and Evil, but between Good and Good.  And they hurt all the more because when we choose between two goods, we know we are hurting someone who does not deserve it.

More later.

Daily Inspections not acceptable

This weekend many of us went through an Aviation inspection getting ready for a visit by the Inspector General.  A warrant officer who is also a Blackhawk pilot is in charge of the security for the aviation facility.  Because this is a highly secure area, they conduct a 100% inventory of keys at the end of every day.

The inspection requires a semi-annual 100% inventory of the keys.  Our security officer showed the inspector the daily log of key inspections.  Since it says "Daily Log" the inspector said it was unacceptable.

Our security officer asked.  "If we are supposed to have an inspection on June 1 and December 1 could I give you the inspection sheets for those particular days?"

"No" was the answer.  The sheets are labelled Daily so they are unacceptable as Semi-Annual inspection verification.

In the area of key security, he was rated "Unsatisfactory."

Clearly, it is important not to accept daily inspections when a semi-annual inspection is needed.

Welcome to the Army.

First month in Iraq, fuelers set up at Camp Normandy

 Roomie, SGT Nickey Smith, goes to Camp Normandy with the fuelers.

Waiting for the bird

Luxury accomodations

 Nice neighborhood!

Commute is Getting Worse

I talked to a guy at Dow yesterday who just returned from four years working in Sao Paulo, Brazil.  He commutes into Philadelphia from Wayne PA and is very happy with the drive on the Schuykill Expressway.  It is a narrow, crowded highway into America's fifth largest city.  But the traffic moves.  Different than driving in Sao Paulo.

Two days of three so far this week my commute home was longer because a train broke down or was delayed.  I was more than an hour late Tuesday, a half-hour yesterday.  The commute is two hours each way already, so delays really suck.

In December I had a different problem caused by the conductor.  I wrote a letter of complaint.

Here it is:

On December 8, 2011, the conductor on the 10:59 pm train to Lancaster refused to allow me to travel on her train.  I believe her name is Debbie.

I have commuted from Lancaster to Philadelphia on Amtrak since 1995 for three different jobs.  Since I returned from deployment to Iraq in February 2010, I have bought monthly tickets and travel to Philadelphia three or four days per week.  I am an avid bicyclist and sometimes bring a folding bike with me on the commute.  I normally travel to Phila at 706am and return at 535 or 642pm.  

I have a folding bike with 20-inch wheels and another bike instead of folding breaks in half.  I then fold the two pieces of the bike.   

On December 8 I worked late.  On the platform Debbie said the bike did not fold so it was not allowed on the train.  I had been bringing this bike on trains for almost a year and said that to Debbie. She said, "That's not true."  Really?  

I am a 58-year-old combat veteran of Iraq with five kids.  I do not often get called a liar to my face.  

My employer covered the hotel room because I had to stay over in Philadelphia.  Debbie said she was concerned about passenger safety, but she had three completely empty cars.  If she thought anyone was in immanent danger from a folded bicycle, the bicycle could have been stored in an empty car.

I did not write immediately because I am treated so well by Amtrak and tell my friends who drive how nice it is to take the train.  My wife and I are also in the process of adopting a child from Haiti.

But this morning I was reminded of just how rude Debbie is.  I am writing this letter on the 706am train to Philadelphia.  I had not seen Debbie since the incident until this morning.  We are in the quiet car.  She is talking loudly.  Loudly enough she was asked to quiet down.  She said, "I am allowed to talk."  When the conductors sneer the rules, even if they are off duty, that is a real problem.

I do not think you should have customer service people who act in an arbitrary and insulting way to customers and disobey your own rules.

I want an apology from Debbie.  

Sincerely yours,

Neil Gussman

Lancaster PA