Tuesday, 21 May 2019

A failing health care system.

   When I decided to emigrate to Canada, it was partly because I felt that I could live with her Health Care System.  I had been an Assistant General Practitioner in a practice in THE London, where I  worked for a group of physicians I liked and respected.  They reciprocated the feelings, at least based on the references they gave me.  (I still read them with some pride fifty-eight years later!).  They offered me a partnership arrangement, based on the prevailing arrangements of the day, which  I rejected.   One of the issues that prompted me to emigrate was the increasing influence of the administrators of National Health Service of Great Britain, not only on the delivery of health care, but on the quality of that care.
   Friends and colleagues have often asked me over the years why I decided to come to Canada.  particularly those who know of my close family relationships in the U.S.  The answer is relatively simple.  I  felt that Canadian medicine represented the best of the British and of the American system, while avoiding the worst of both.   Alas my opinion has changed over the years as I have seen the steady deterioration brought about by the politicization of health care.   We have gone from being one of the best systems in the developed world to becoming one of the most poorly rated.  The Canada Health Act has condemned Canadians to mediocre medicine at best, to shameful neglect at worst.  Furthermore the hubris of elected officials has assured that Canadians have been prohibited from seeking health care privately as is available in most of the developed countries in the world.  For the most part that has forced patients who are dissatisfied with the public system to go outside the country or to seek one of the low-profile sources that manage to exist because the prohibitions imposed by government are being challenged in the courts.  Unfortunately, the administridiots now control medical care and have turned it into a political game in which votes come first and patient care comes last.
   All of which is the introduction to one simple example I am  going to  share with you.  Because, even in this age of pseudo-respect for confidentiality, nothing is private, I will avoid identifying persons in this story that a friend of mine shared with me very recently.  The following account does not presume to record the actual clinical events in detail, but rather to give an overview of  my interpretation of what Rose told me took place.
   It was approaching midnight when Rose heard a loud clatter coming from the bedroom.   It was unusual  for Tom to still be clattering around at this time of night, so she went  into the bedroom to see what might be going on.  She was not a person who panicked easily, but when she saw her husband spasming on the bedroom floor, she panicked.  Even under those circumstances she reacted quickly and efficiently.  She called 911 and ran to his side to help in any way she could.  By then, he had stopped seizing.   The emergency response was timely and appropriate and Tom was taken to the nearest ER for management.  Rose was not allowed to accompany him  in the ambulance, so despite being thoroughly shaken up, prepared herself to drive to  Emergency to be at her husband's side.   
   Fortunately her neighhbour had been disturbed by the ambulance and came rushing over to help.
   "I think Tom has had a stroke  and they are taking him to  the Emergency Room.  They won't let me ride in  the ambulance so I  am going to drive right over there now." said Rose.
   "You can't  drive anywhere in the state you're in.  Let me grab my coat and I'll drive you to the emergency room."
   She dropped Rose off by the entrance.  Rose went in and introduced herself . The Doctor had seen Tom and had arranged an emergency CT scan as well as X-Rays and blood work.   Many hours later, when the tests had been completed and  interpreted, the doctor came over to talk to Rose.
   "Your husband has two tumours," he said, "one in the brain, the other in his lung."
   " Oh my God, what do we do now?" she asked, deeply distressed.
   "He needs to be evaluated by a neuro-surgeon and we are going to set up an appointment.  Meanwhile you can take him home now and we'll be in  touch with you regarding the appointment."
   "Will someone be seeing him tonight?" she asked.
   "Oh no," said the doctor.  "We will have to arrange an appointment.  You can take him home now and we'll be in touch with you."
    Rose felt a surge of panic welling up inside her."What if he has another seizure when I take him home?" 
   "We have started him on anti-convulsants and I will write you a prescription to keep him on, so that will probably keep things under control for the moment.  If he did have anything further in the meantime just bring him back here."
   Shaken badly Rose called a taxi and took her husband home so she could worry herself sick about him.
   A week went by and Rose had heard nothing. She had to phone the Emergency Department and her family doctor who knew nothing about the event.  
   When I talked to Rose a few days later she finally had a date for the appointment which had not yet taken place. Her stress level remained as high as one would expect.
  Now let me tell you how this would have been managed in the 'bad old days' when  I was a family doctor:
  The patient would have phoned the clinic her family doctor worked in, where a member of the group was on call on a twenty-four hour roster.  The patient would  have been patched through to the on- call doctor who would have met the patient in Emergency, examined him and prescribed what was necessary. This patient would undoubtedly have been ADMITTED to the hospital for observation and management and would have been seen as an emergency consultation by the neuro-surgeon in the morning,   Meanwhile, the family knew the patient (yes, I still call them patients!) was at least in a setting where immediate attention would be available if necessary.  Thus the patient was in a safe place where he would be appropriately monitored and the family/caregiver was relieved of some of the stress in a high stress situation.   
   These changes have come about because the administridiots that the Government put in charge of health care are more concerned with votes and appearances than with patients and they know it is easy to download the blame to the doctors and nurses and other health care workers on whose shoulders the whole system is carried.  

Many people share stories like this one with me. If you have one you'd like to share, contact me.  Obviously no identifying data would be published.



Tuesday, 14 May 2019

Maybe a Funny Story! But who Nose?

   When I was a young physician,,  newly located in Regina, Saskatchewan, I was overwhelmed by the welcome that I received when I first arrived. People went out of their way to welcome us.  Some of the friends I made in those days remained my close friends until they passed on to the happier hunting grounds.  There are many stories about those days, some funny and some not  so  funny.  I write about them from time to  time.  I think is a funny one.
   When I walked into my examining room in the Department of Family Medicine at the new Plains Health Centre in Regina, Saskatchewan, I found a 'middle-aged' male looking at an article in Time magazine.  It so happened he was looking at a picture of a woman just one year older than me - Sophia Loren.  At that time, I thought that Sophia was the most beautiful woman in the world.  Enough said.
   "Ah," said I, "A beautiful woman."
   "Not so beautiful,"  he said sourly.
   I was immediately perturbed at my idol being thus dismissed.
   "What do you mean?" I asked.
   He spread out the "Time " Magazine in front of me.  "Look, she owes all of her success to her Jewish Producer," He pointed at the photograph of her, sitting next to Joseph E Levine.  It is true that Levine played a considerable part in Loren's success story.
   "Oh," said I taken aback. "And what makes you think he's Jewish?"
   "Just look at that Jewish nose?"
   Well, even in those halcyon days, a physician couldn't tell a patient just what he  thought of him.
   "Think that's a Jewish nose, eh!"   I raised my right fore-finger-tip to the tip of my own perfectly shaped nose. "You're wrong, THIS is a Jewish nose!  "
   The patient looked a little embarrassed and I was probably wrong to allow personal feelings to surface.  Too bad!   In retrospect, I think I reacted appropriately and would do the  same again, though probably with disastrous consequences.  I would still bet the bank that he didn't fill the prescription I handed him after I had dealt with  his medical problem.
   I'm glad I lived before the politically correct era !!
   By the way, I have enjoyed great mileage from relating this story at various celebrations!!

Tuesday, 7 May 2019

Rules for Radicals. Pt.2.

"In the beginning, the organizer's first job is to  create the issues or problems"
Saul Alinsky, Rules for Radicals.

In other words, Alinsky is saying, that if there is no problem, there is a need  to create one.   Once created, if that problem catches the imagination of the public, it can destroy the status quo (i.e. go viral).    If the status quo can be destroyed, that leaves a vacuum for the 'New Society' that the LWLs (Left Wing Looneys) imagine they can impose on Canadians!

    In the previous century, to which I belong, liberalism meant fairness. My parents were liberal and most Jews were small  'l' liberals.   They needed a job, they wanted everyone to have a job.  They wanted to make a living.  They wanted to educate their children.  They were decent people who wanted to make a decent living for a fair days work.  They wanted to educate their children and they wanted their children to have a better standard of living than they themselves were able to attain.  That has all changed.
   Now, the "Liberal " leaders are multi billionaires.   The Left Wing Loonies, disguise themselves as 'Liberals' to protect themselves.  The most effective way that the 1% can protect themselves is by pretending that their mission is  to  improve the  lot of what used to be called 'the Working man'.   There is much less likelihood  of a rebellion if the 'elites' can convince the populace that they are working on their behalf.

   Alinsky's Rules (with my comments).
1. "Power is not only what you have, but what the enemy thinks you have."
This is a polite way of saying 'Bullshit beats brains.'. If you can intimidate the enemy sufficiently you are well on the way to winning. Much of the left's strategy is based on trying to intimidate their opponents, with considerable success. Their opponents are only just beginning to realize that defending themselves against baseless charges of racism and bigotry simply lends credibility to the charges. There is no reasoning with these people and the only rebuttal is to put their own behaviour and credibility under the microscope.

2. "Never go outside the expertise of your people.". Feeling secure adds to the backbone of anyone.
In other words don't let them catch you being in the wrong. Better to make no comment than to make an incorrect assertion that can come back to haunt you.

3. "Whenever possible, go outside the expertise of the enemy."
For the reason above - in reverse!

4. "Make the enemy live up to its own book of rules."
Study the enemy's book of rules and assertions. Catching them contravening their own codes damages their credibility.

5. "Ridicule is man's most potent weapon."
If one can effectively ridicule one's enemy and make him look silly you can undermine his ability to lead.

6. "A good tactic is one your people enjoy."
Puff them up, pump them up, make them feel important, no matter how unimportant the mission is.

7. "A tactic that drags on too long becomes a drag."
They have to feel they are achieving something important.

8. " Keep the pressure on. Never let up."
Make accusations, the more outrageous the better. If the lie is big enough it is likely to be believed.

9. "The threat is usually more terrifying than the thing itself."

10. "The major premise for tactics is the development of operations that will maintain a constant pressure upon the opposition." 

It is this unceasing pressure that results in the reactions from the opposition that are essential for success.
Relentless accusations tend to be believed, especially when a little salacious.

11. "If you push a negative hard enough, it will push through and become a positive."
Eventually you can aggravate your opponent into doing or saying something that is not in their best interests.

12. "The price of a successful attack is a constructive alternative".
Put forward any solution, even a weak or outlandish one - a lot of dopes will buy it anyway.

Enough of this for now.  Time to lighten up for a while.  A little light comedy next.


Monday, 29 April 2019

Rules for Radicals.

 So, who is  Saul  Alinsky , anyway?
   First, let me tell you that without him, the 'Hill-Billy' Clintons, the diabolical Obamas , the "Moronic Man-Child" (Trudeau), could not have thrived to become the virtual rulers of the civilized world.   And much much more!                                                      
   The leaders of the developed world are primarily interested in maintaining power and are prepared to do anything to keep it.   Almost everything else they have to say are lies and some liars are much worse than others.

George Orwell

“Power is not a means; it is an end. One does not establish a dictatorship in order to safeguard a revolution; one makes the revolution in order to establish the dictatorship. The object of persecution is persecution. The object of torture is torture. The object of power is power.”

― George Orwell, "1984".
tags: p

    Saul Alinsky was a community organizer in  Chicago (Obama - town)  He had also been a mentor to  Hilary Clinton.   He is considered to be the founder of modern community organizing which was directed at destroying the existing order and replacing it with anarchy.  He was born in  1909 and died in 1972.  His most noted work was titled;  
"Rules for Radicals: A Pragmatic Primer for Realistic Radicals." 
   A 1971 book about how to successfully run a movement for change, it was the last book that Alinsky wrote and was published shortly before his death in 1972. His goal was to change he power structure in the United States.]  Rules for Radicals deals with uniting people to effect changes in  societal structure and to eliminate the capitalist structure of society and redistribute the wealth of the country regardless of the contribution of the citizens.   A very inviting concept to those who don't want to work much or not at all, but not so inviting to the hard-working successful folks who  have struggled to achieve what they have.
   Though published for the new generation of counter-culture era organizers in 1971, Alinsky's principles have been successfully been applied by numerous government,labour, community and  congregation based organizations and the main theme of his organizational methods that were elucidated upon in Rules for Radicals have been recurring elements in political campaigns in recent years.  
   Alinsky  was a mentor of Hilary Clinton; the Clintons and Obama, himself a Chicago community organizer, based their  anarchic philosophies on his teachings.  The Democratic  party came  to increasingly adopt his philosophy.  That philosophy is well outlined in his book 'Rules  for Radicals', written not long before he died.  Use of his rules demand the identification of an 'enemy' at whom they can ruthlessly and relentlessly be directed.
  In brief here they are. Elaboration will follow later.

The Rules:
"Power is not only what you have but what the enemy thinks you have."
"Never go outside the expertise of your people."
"Whenever possible go outside the expertise of the enemy."
"Make the enemy live up to its own book of rules."
"Ridicule is man's most potent weapon."
"A good tactic is one your people enjoy."
"A tactic that drags on too long becomes a drag."
"Keep the pressure on."
"The threat is usually more terrifying than the thing itself."
"The major premise for tactics is the development of operations that will maintain a constant pressure upon the opposition."
"If you push a negative hard and deep enough it will break through into its counterside"
"The price of a successful attack is a constructive alternative."
"Pick the target, freeze it, personalize it, and polarize it."

Come back later, if you want to know what this all means and how Saul Alinski has brainwashed you! Feel free to comment.

Thursday, 25 April 2019

The Second Coming. W.B. Yeats.
(Perhaps it would have been better titled 'The Decline and Fall of the West'.)

Turning and turning in the widening gyre
The falcon cannot hear the falconer;
Things fall apart; the centre cannot hold;
Mere anarchy is loosed upon the world,
The blood-dimmed tide is loosed, and everywhere
The ceremony of innocence is drowned;
The best lack all conviction, while the worst
Are full of passionate intensity.

This poem by Yeats, written between WW1 and WW2 describes our current situation with uncanny accuracy.

Do you ever wonder what's happening to the world, now?
I do and I'm not optimistic. The Millennials (starting in the early 80s to the early 2000s) are in for some rude realities that they do not understand and that will affect them and their offspring. It is not going to be a pretty picture.  
How did we get here? How did the American Dream become a nightmare?
One man, played a major role in the modern march towards anarchy and the destruction of the relatively stable society we have enjoyed since WW2.
The name of that man? Saul Alinsky. My blog will investigate and elaborate on his role. If you have never heard of him and his book "Rules for Radicals", you may get a surprise. Particularly when you learn how successful he was in undermining the relatively stable society I grew up in and replacing it with the worsening state of anarchy that exists today and how Obama and his sycophants including Trudeau adhered to his playbook.
Come back here for more.

If you have any views - spit 'em out!!

Tuesday, 2 April 2019

It Really Looks as though Stupidity is Incurable.

It really looks as though stupidity can't be cured!
The Anti-vaxxers are at it again. They have an incurable disease - stupidity. As the punchline of the joke my father told me a hundred years ago went, the Village Idiot, (yes, long ago villages used to have idiots before all the idiots went to university and became really dangerous) said:
"People think I know Fuck Nothing, well, I''m telling them, I went to University I know Fuck all!"
The joke is not a joke anymore. People who know nothing about health care, often semi-literate, now think that they know more than professionals who have dedicated a significant part of their lives studying and delivering health care to the population, often at great cost to themselves and for the most part with amazing success. The greatest advance in modern medicine has been the prevention of disastrous, often crippling sometimes fatal disease through immunization, not the glamorous procedures that make such good television.. Many of the life-threatening diseases I used to see no longer exist, thanks to immunization. There are many other infectious diseases that were on the brink of elimination that are gaining momentum such as measles, mumps, rubella, diphtheria, pertussis and others.
And what do the Snowflakes think?  
They, in their ignorance, think immunization causes autism, despite extensive hard science investigation that proves it doesn't 
"We really know more that this quack," they say of gifted scientists who have spent their lives studying these issues, " we feel it, yes we feel it in our hearts."  
They never saw smallpox, a disease that no longer exists. They have never seen or even know about poliomyelitis, that left children in 'the iron lung' because they couldn't breath or, if they recovered paralyzed with withered limbs. They never saw people with rheumatic fever who sustained heart damage that left them crippled for life. I could go on at length.
They know little about medicine yet they inject doubt into the minds of others. Unfortunately, some of these ignoramuses (OK ignorami ) are influential. Not only do they do immeasurable damage to their own children and grandchildren they do it to yours and mine.
Attempts to educate the Ignorami have been in vain and although the province of Ontario has spent significant money on educational programs, less than 1% change their view.
Read Roald Dahl (of Charlie and the Chocolate Factory fame) who lost a seven year old daughter to measles. His published letter titled “Measles: A Dangerous Illness,” was re-published by The Encephalitis Society Fact Sheet
to remind the public of the dangers they are subjecting their children to based on false science.
The anti-vaccination movement was initiated by a British Physician called Andrew Wakefield.
In 1998, a British physician and twelve of his colleagues published a small case series in the Lancet, a prestigious British medical journal that suggested MMR (measles, mumps, rubella) vaccine may be related to autism. MMR vaccination rates began to drop almost immediately as a result of that. Subsequent studies did not confirm any such relationship and ten of the twelve authors refuted the interpretation of the data on the basis of insufficient evidence. Further, it emerged that Wakefield et al had failed to disclose that they had been funded by lawyers who were engaged by the parents in legal suits against vaccine producing companies. Ultimately, Wakefield et al were found guilty of deliberate fraud and fabrication of facts apparently for personal gain. Wakefield was removed from the General Medical Council of Britain's register and was no longer permitted to practice medicine, emigrated to America where he became an instant hero, to lead and encourage the development of the 'Anti-Vaxxer' movement which would lead a significant group, many of whom should have known better, back into the dark ages.
So how is it that so many allegedly educated elitists buy into this absurd theory that measures which have done more to promote health and eliminate horrible disease are not healthy, are not natural and therefore should be avoided. How is it that these allegedly educated dopes cannot understand that what is natural is for people to die of infection, of pneumonia and indeed even of sepsis from an infected finger? Can they not understand that it is natural for one in five children to die in childbirth along with a goodly number of mothers? Can they not understand that pain and suffering is natural and that it is quite unnatural to remove those natural warnings? Do they not take antibiotics when infected or painkillers when in pain? You bet they do! Can they not understand that freezing to death is natural and that central heating and burning of fossil fuels is unnatural? Can they not understand heat and humidity are natural and that air conditioning is horribly unnatural? Those poor feckless milksops are to first to cry out for those unnatural balms that they so despised, as soon as they perceive it will spare THEM a little pain and suffering.  
Of course some really do understand what it is all about. They want to parade their ignorance as though it were knowledge. Many believe that their unscientific and uneducated views are "equal" to those of scholars and scientists who have spent their lives studying those topics. They are not, but unfortunately they can still do immense damage and inappropriately enjoy considerable credibility, while the herd immunity that the last generation acquired and offers them protection. Fortunately, most sensible folks protect their children, but we are going to see more outbreaks of these once well controlled diseases as immunity wanes.
Meanwhile, the pseudo scientific simpletons will continue to consider themselves as a elite group entitled to mislead their fellow beings.
Dr. Wakefield and his ilk will thrive as long as they can recruit the self righteous and the gullible!
The anti-vaxxers are subjecting their children to unacceptable hazard that borders on abuse. They are also subjecting the community as a whole to hazard as the herd immunity wanes.
It is time for the Government to show some leadership and make immunization mandatory as is done in many other countries.

Thursday, 28 March 2019

Poolside Chats: Pt3.

Naples is a nice "little" city. that has traffic like a big city. (This from a guy used to driving the 401!). Many of the roads have four lanes in each direction and the speed limit within the city is 45mph, miles not kilometers. I actually looked up the population and was amazed to find hat the year round population was a mere 25,000 or so, with a seaonal peak of about one third of a million (less than the city I live in!). Most of the drivers seem to ignore the speed limit and just drive at whatever speed they want, usually closer to 60mph than 45mph. Quite apart from that they tailgate, hop lanes and seem totally averse to signalling. Hardly a day went by without witnessing at least one collision. Was this just me getting a little older ? However, I was doing my laps in the pool one day, eavesdropping as I always do, (if I'm close enough to hear) when I overheard two fifty-ish men talking poolside about local traffic conditions.
Man # 1: "Roads here are a real hazard, aren't they? I'm a little nervous on these roads."
Man # 2: "I can't believe the speed they drive at. No signals, changing lanes without warning,cut you off regularly. I think I've seen an accident every day I've been here."

"Hey!" I chipped in as I swam by, "I just thought it was just me getting old."
"Hell no," man one answered, "and we're used to crazy drivers, we're from Chicago!"
I felt much better that it wasn't just 'old fogiism!

I got to know them over the next weeks while lazing around the pool, so when I found them in animated conversation while they were sitting sunning themselves I thought I'd better chip in.  
"Hey, what's up?" I smiled."You guys seem a little worked up."
"We're both managers in a steel works, different companies so we're comparing problems we have to deal with. One of our biggest problems is serious accidents in the line workers usually due to intoxication on the job. It's a huge problem and likely to become greater now that marijuana products will be more available. "
We had discussed the legalization of marijuana in Canada and they were well aware it would be coming their way soon.
"Yes, " said Steelman 2. "We've had some really horrible accidents. We had a woman decapitated recently. Guys roll in after their lunch stoned out of their mind but unless it's pretty obvious we can't do much about it. They have a strong Union and they usually succeed in curtailing any disciplinary action except in the most outrageous cases. Soon they'll be rolling in with a prescription for Medical marijuana from their doctor demanding they need to smoke a joint on the job."
"Ah well," said Steelman 1, " I'm retired this year with all my medical benefits. To tell you the truth, I would have retired a couple of years ago if it wasn't for my medical plan. The only problem is my wife is a few years younger than I am and she can't retire yet or she would lose her medical benefits and that's a big thing.. Looks like I am going to be spending the winters down here by myself a lot of the time, while she's freezing in Chicago."
"So you are down here by yourself?"
"Yes, we bought a condo here last year and we don't want to leave it empty. She comes down here for a long weekday, or sometimes four or five days, whenever she can get away but then she has to get back to work. Just last week her flight back was cancelled so she had to get a regular flight back, which set us back $600 instead of the $199 it usually cost on sale, but she had to get back to work! Once she retires we'll probably move down here permanently." 

"That's nice."
"Yes," He pulled a face, "but June, July and August are hell here, so we will have to experience a summer here before we make the final decision to move."
"Tough!" I said, only slightly sarcastically, but then I was going home to the arctic temperatures the next day!
The trip home was uneventful apart from the lengthy trip from Pearson International to the domestic flights which must have been over a mile, for the forty minute flight to London. Counting the layover time, I could easily have driven the distance in half the time!