A great gig at the time

In the late 1940's, Mr. F. was a teenager (he's now 79 years old).

He grew up in Brooklyn, NY.

He would ride his bicycle around town for hours everyday.

One day he stopped to try and look over a wall that surrounded a Mansion.

He was pretty sure it was the home of someone in the Mob.

"Hey kid," yelled a security guard, "come over here."

"I was always a pretty confident kid and I knew I hadn't done anything wrong," said Mr. F., "so I went on over instead of running away."

"Do me a favor," asked the security guard, "go pick me up a copy of the Daily News and the Daily Mirror and bring them back. Here's a dollar (both papers only cost 3 cents a piece)."

"I brought the papers back and he told me to keep the change. 94 cents! That was a lot of money for a kid back then. Hey mister, I asked the guard, do you want me to bring you the papers tomorrow? For about the next year and a half I made almost 5 dollars a week. I didn't tell any of my friends. They just thought it was always great I  had some change and could occasionally buy them a piece of candy."

Just an Olympic Silver?

Elizabeth Beisel, a 19 year-old American was favored going into the 400 meter IM Olympic final.

She lost to Ye Shiwen, a 16 year-old from China.

After the race, the NBC interviewer asked her a question along the lines of, "how disappointed are you in your performance having only received the Silver medal?"

She was mature beyond her years when she answered, "you know, everyone was so nervous before the race and I did my best. I'm really proud to have won a Silver medal at the Olympics."

I couldn't agree more.

Maybe interviewers would stop asking such idiotic questions if more athletes gave a similar answer?

Probably not, unfortunately.

What second stop?

We went on two more college tours recently for our son who is entering his senior year of high school.

Both are highly rated private colleges with a tuition in the $50,000/year range.

Both had an information session, by an admissions counselor, prior to the tour.

At the first stop, the admissions counselor made a comment along the lines of, "from the minute your child steps foot on this campus, he/she will have a faculty adviser assigned to assist in helping your child determine an area of interest, through course analysis and personality testing, so that he/she will have a career path in mind after the first year of study and to make sure he/she will graduate within 4 years."

At the second stop, the admissions counselor made a comment along the lines of, "we're a liberal arts college. Students need to explore their inner feelings here in depth. We encourage them to take a smattering of courses, take reduced hours if stressed-out, take a semester off if needed, experiment with different paths of study, take a broad spectrum of courses for the joy of learning...most will not graduate within 4 years, but that's OK. They should take as long as they need to find themselves."

On returning home, my wife and I made a pact to never mention the second school out loud ever again. We will also be keeping an eye out to get rid of any correspondence (snail mail or e-mails) from the school who must not be named (for the Harry Potter fans).

Trying hard not to become a computer

The Electronic Health Record (EHR) has definitely had an impact on the Physician-Patient relationship.

Here are a few of my thoughts from an article just published on the Physicans Practice website:

http://www.physicianspractice.com/print/article/1462168/2090136?printable=true

Fiftieth place

England put on a great opening show for the London 2012 Olympics.

One section included a tribute to their National Health System (NHS) that was launched in 1948 with the following three goals:

That it meets the needs of everyone, that it be free at the point of delivery and that it be based on clinical need, not on the ability to pay

An excellent article on the NHS appeared three years ago in Time magazine:

http://www.time.com/time/health/article/0,8599,1916570-1,00.html

While we continue to debate all the pros and cons of our health care delivery system in the United States other, recently updated, statistics are also interesting to review.

While the United States remains strongly seated in the #1 position for most health care dollars spent/person, the U.S. is currently in 50th place in terms of average life expectancy:

http://www.nationalledger.com/lifestyle-home-family/life-expectancy-by-country-201-185296.shtml#.UBPhm2FfESY

While debate is still needed, action is also. A few years ago we were 38th.

No C squared tonight

It's Friday evening.

It's the end of my first week back after our trip to Italy.

We may go out and grab a bite to eat.

Nothing fancy; just nice and simple. We will probably just go to an old stand-by, Tijuana Flats.

But, I'm looking forward to two things:

#1 Free water-there's no such thing as free water at restaurants in Italy. Even acqua di rubinetto or, as we say, tap water, was served in a Carafe (and not a large Carafe) and would be about 4 euros/Carafe.

#2 No Coperto: "the seating charge" added to every bill. It was usually anywhere from 2.50 to 4 euros/person. It was originally started years ago to cover the cost of washing the linens and providing the free stuff-like pane or, as we say, bread.

(We spent a fair amount of money but it didn't feel like it because euros look/feel so much like monopoly money!)

So, a meal out without a Carafe or Coperto (C squared)!

We had a great time in Italy but it's good to be home!

No oops-please!

My son had his wisdom teeth out yesterday.

He reported the last thing he remembered, before being put to sleep, was the nurse saying "oops."

It made quite an impression.

It was the first thing he wanted to talk about when he woke up and could talk in a manner in which we could actually understand what he was saying (after the anesthesia wore off).

We're still trying to assure him that everything went well-at least that what we were told by the oral surgeon

"Oops" is probably the number one thing you should never say to a patient.

It's been known to strike fear in even the toughest of patients.

My son's a pretty tough kid.

No pain for me

There are many things a physician should never say to a patient.

"This won't hurt at all," is one such statement.

Many physicians seem to overestimate their ability at performing certain procedures painlessly. The fact is, many procedures do hurt, at least a little. I can easily attest to that. I even find having my blood drawn to be objectionable at times.

The recommended terms to use are "this could be a little uncomfortable" or "this will hurt some, but it'll be over before you know it."

I still laugh about a former orthopedic colleague. He would always inform patients that the office procedure he was about to perform "won't hurt me a bit, so don't worry."

It served as a good tension relief, for the few patients who got it, when they could laugh together.

An expensive Pepsi

Brazilian soccer star Ronaldinho recently showed up at a news conference drinking a Pepsi.

Only problem was that he had an endorsement deal with Coke at the time for $750,000/year.

Coke voided the contract.

I suspect he never thought of the consequences of his actions.

It's completely understandable given his most recent salary of $24,000,000/year.

I'm not sure if there's any interest but I'll just throw it out there...I love Coke and hate Pepsi.

Does anyone use a bidet for it's intended purpose?

We stayed in 5 different hotels while traveling in Italy.

All had a bidet ( a basin near the toilet that's used to clean the genitals and anal area after using the toilet or whenever a "freshening up" is needed) in the bathroom.

All had a slightly different angle in which the water would spurt up or out. All went unused.

Upon return home I investigated a little further.

It seems many have found some good uses for a bidet while traveling. Here are a couple I came across on the internet:

Some seemingly ignored Italian health warnings

We just got back from Italy. We spent time in the following cities: Venice, Bologna, Florence, Pisa and Rome. At all stops along the way we were blown away (literally) by the number of folks who were smoking. Cigarette machines, with often very young folks making a purchase, seemed to be everywhere. 

The whole time I kept wondering, "do Italian cigarette packs have a health warning?"

Surprisingly they do. I would have guessed not. Here's what I found concerning the health warnings on Italian packs when I returned home:

Il fumo uccide (Smoking kills)

• Il fumo uccide / Il fumo può uccidere. (Smoking kills / Smoking may kill)
• Il fumo danneggia gravemente te e chi ti sta intorno. (Smoking heavily damages you and whoever is near you)
• I fumatori muoiono prima. (Smokers die early.)
• Il fumo ostruisce le arterie e provoca infarti e ictus. (Smoking clogs arteries and causes heart diseases and strokes)
• Il fumo provoca cancro mortale ai polmoni. (Smoking causes fatal lung cancer.)
• Fumare in gravidanza fa male al bambino. (Smoking during pregnancy harms the baby.)
• Proteggi i bambini, non fumare in loro presenza. (Protect the kids, don't smoke in their presence.)
• Il medico o il tuo farmacista possono aiutarti a smettere di fumare. (Your doctor or your pharmacist may help you quit smoking.)
• Specialisti del settore medico possono aiutarti a smettere di fumare. (Specialists in the medical profession may help you quit smoking.)
• Il fumo crea un'elevata dipendenza, non iniziare. (Smoking is highly addictive, don't start.)
• Smettere di fumare riduce il rischio di malattie cardiovascolari e polmonari mortali. (Quitting smoking reduces the risk of deadly cardiovascular and lung diseases.)
• Il fumo può provocare una morte lenta e dolorosa. (Smoking can cause a long and painful death.)
• Il fumo provoca il cancro della cavità orale. (Smoking causes oral cancer.)
• Fatti aiutare a smettere di fumare. (Let us help you quit smoking.)
• Il fumo può ridurre la circolazione sanguigna e causa impotenza. (Smoking may reduce blood circulation and cause impotency.)
• Il fumo invecchia la pelle. (Smoking ages the skin.)
• Il fumo può danneggiare lo sperma e diminuisce la fertilità. (Smoking may damage sperm and diminish fertility.)
• Il fumo contiene benzene, nitrosammine, formaldeide e acido cianidrico. (Cigarettes contain benzene, nistrosamine, formaldehyde and hydrocyanic acid)

I looked at a few discarded packs while there but couldn't translate the messages at the time. The few Italian words I picked up only included Grazie, Prego, Si, No, and, of course, my most frequently spoken Italian word, Gelato.

Help wanted

This blog was started a little more than a year ago.

363 posts later, it's still been a lot of fun.

It's my attempt to continue writing on funny/unique/interesting patient encounters and personal stories as a follow-up to the three short books previously published: Patients Say the Darndest Things (2003), Patients Say the Darndest Things-Volume 2 (2006) and Patients Say the Darndest Things-Volume 3 (2009).

I've encouraged others, who like to write, to start a blog. It's an easy, and inexpensive, way to put your thoughts down on paper. It's best to just start writing without the expectation that others will even read it.

I try to keep most posts relatively short, for obvious reasons. I know everyone already has a pretty full plate.

I do occasionally check the STATS section that is available only to the author. One day over 90 folks had stopped by to read the blog (I do admit, that was pretty cool).

So, for the first time, I'm going to ask for some/any input and suggestions at:.

patientssaythedarndestthings@gmail.com

I'm going to take a couple of weeks off to give y'all some time.

Any thoughts would be greatly appreciated.

Thanks!

A fire angel for the people

Mr. H. is now 86 years old but appears to be much younger when reminiscing about the old days.

He worked for years as a New York City public fire appraiser representing the people versus the Insurance companies for damages sustained to property in a fire.

In general, he worked for commissions-usually 5-10% of the pay-out.

However he would never take a commission when representing, for example, a single mother trying to raise a family. "It just wouldn't have been right to profit from their loss and money was often so tight in those days."

The appraisers who worked for the Insurance companies were always trying to force a settlement of a claim for the least amount possible. Mr. H.'s goal was just the opposite.

He reports he was considered a "hero" to the people but "a thief and a whore" to the Insurance companies.

He worked in and around a very tough and street smart clientele, including the Mob.

He says he got along with most folks well because of two simple life rules:

1. If you cross paths with someone who isn't civil with you, just walk away.

2. You don't have to like people, but if you do the right thing, they will like you.

As an aside, I couldn't believe he had never smoked cigarettes.

"Why?" he asked.

"It just surprises me that you never smoked given the nature of your business and the people you worked for back in those days."

"Well I never used a prostitute either, even though I worked around them everyday as well."

Touche, I thought, well stated.

A perfect arrangement

Mr. and Mrs. V. are an amazing couple.

They've been married for 62 years.

Both were from Sicily and it was an arranged marriage.

He came to America when he was 18 and served in the Army until the end of WWII.

He was 23 and she was 15 when they married.

He's now 85 and she's 77.

They raised three children; all are college graduates with careers and families of their own.

Mr. V. was also a successful business man.

He now has advanced Alzheimer's disease.

She remains by his side.

"It breaksa my heart to see him this way, but we've had a great life together and he's been a great husband and father. I have no regrets over the life we shared together, we were so blessed," she says while gently stroking his hair.

Until well into the late 1950's, most Sicilian marriages were either formally arranged by the parents or permitted only with consent, unless the couple eloped.

"The intra-generational relationship of the family was felt to be more valued, initially, than the marital relationship. The whole purpose of a marriage was to have a family. Even if the couple did not love each other at first, a greater understanding between the two would develop, aided by their often similar socioeconomic, religious, political, and cultural backgrounds."

Proponents also felt as if marriages based on just romance were doomed to failure.

The divorce rate was also quite low. Nobody wanted the two families to have a problem. The only choice was to keep the marriage going.

I know a  lot of Mediterranean marriages were also accompanied by the presence, in the background, of a mistress. Opponents often site this as an example of the need for attraction and romance in a marital relationship.

I can see both sides of the argument.


Regardless, it's clear that Mr. and Mrs. V. were a perfect match.

Have a GREAT 4th of July!

"My God! How little do my countrymen know what precious blessings they are in possession of, and which no other people on earth enjoy!" Thomas Jefferson

"And I'm proud to be an American, where at least I know I'm free.
And I won't forget the men who died, who gave that right to me." Lee Greenwood

The book title doesn't appear to be right

A local Doctor and his wife just unveiled a new diet book entitled, "Lose Weight, Get Healthy & Be Happy: the Rice Diet is the Right Diet."

I did some brief research on the Rice Diet.

"Created in 1939 in Durham, North Carolina, the Rice Diet is a program that can help you overcome weight-related diseases like obesity, heart disease, diabetes, hypertension and others."

The Rice Diet appears to have some very appealing example menus to choose from (said sarcastically).

For example, for Breakfast:

Choice A: one cup of brown rice, one cup of fresh fruit and unsweetened coffee/tea

Choice B: one cup of brown rice, one small glass of OJ, 2 figs or prunes, and unsweetened coffee/tea

For Lunch:

Choice A: one cup of brown rice, one cup stewed tomatoes, raw carrots or cauliflower, and one glass skimmed milk

Choice B: one cup of brown rice, one cup of boiled cabbage, and one glass of skimmed milk

Etc., etc. (I think you get the general idea).

I'm always up for reading. I'm just thinking the title might need to be changed to "Lose Weight & Get Healthy: the Rice Diet is the Right Diet."

I'm pretty certain I would lose weight.

I'm just having a hard time with the "Be Happy" part!

Animal House a reality: 7 years of college down the drain

There were some troublesome statistics listed in a cover article in the Orlando Sentinel this past weekend; especially for parents who are getting ready to send their kids off to college (like my wife and I in the next two years).

Of the students who start at FAMU (Florida A&M University) as a freshman, only 12% finish their undergraduate degree within four years.

A lot of other Florida state universities are not much better (in fact, it's frightening):

FAU 15%, FIU 19%, UNF 20%, UWF 20%, UCF 35%, FSU 56%, UF 65%.

We have started to plant the seed-our expectation for our kids, where ever they go, will be to finish their undergraduate degree within four years.

It's hard to know what's more impressive; finishing an undergraduate degree at a school with a higher graduation rate or for example, being the just one in five who finish an undergraduate degree within four years some where else.

This is one more variable that comes into play when looking at which schools have the best chance of helping to meet our kids needs. It should be interesting.

Wow, those sure are some white teeth!

Having incredibly WHITE teeth seems to be a must for many folks these days.

This trend started a few years ago but initially seemed to involve only famous people (TV personalities, athletes, etc.).

But now, BLINDING WHITE TEETH are frequently seen even among us common folks.

At times, it almost looks too unnatural.

I'm sure, however, that the cosmetic dentists hope this trend continues for many years to come-at least until they have paid off their homes, cars and put their kids through college.

How did it all start?

I have a theory.

Someone, somehow, somewhere, came across a bunch of Mr. Ed (the talking horse) re-runs and thought it looked good.

I think we need to give credit where credit is due.