Public Health and Pediatrics

“You’d better behave or the doctor is going to give you a shot!”

How many times have you heard this refrain?  This is likely number 1, or at least 1A on my list of irritating things a parent would say to their kids during a visit to our pediatrics office over the years.  The kiddos are often scared enough as it is; they don’t need their parents, the ones they likely trust the most, to conjure up a vision of an evil doctor filling a 3 gallon syringe with a 2 foot stainless steel needle filled with who knows what.  All the while ready to plunge it into any misbehaving miscreant of a child at the slightest provocation. 

 

 

Why would a parent say this?  For some reason I don’t think it started one day, many years ago, when some mom told her kid to behave and when the little tyke didn’t, the doctor piped up and said, “You know, I have just the thing to make that little turd shape up!” and proceeded to call in his large, beefy, nurse to whip out a needle and plunge it into the derrière of the reprobate child.  Thereupon, the mother, seeing this wonderful discipline technique, proceeded to spread this new gospel far and wide, where it has stuck in the consciousness of  America’s mothers ever since.

I suspect the more likely reason is because their parenting skills are so stunted or they are so lazy that they can only elicit good behavior by threatening their children with made-up images of bogeymen in every aspect of their children’s lives.  I wonder what else they say to their offspring throughout the day-

“You’d better behave or that taxi is going to come over here and run you over!”

Or…

“You’d better behave or that cook is going to come over here and scald you!”

Or even…

 “You’d better behave or that lifeguard will drown you!”

 

What I often found myself wanting to say was, "No, Johnny, I'm not going to give you a shot, but I might have to give one to your idiot parent."

At any rate, this is not the best way for parents to encourage the establishment of a nurturing, safe, and effective medical home.  It is more likely the way to encourage the same behavior in the next generation.

 

Dr. K    

Medicare cartoons!

I'm going to step into this one gingerly. I have never seen a Medicare patient in my entire career. True, as a pediatrician, I never had the occasion to. I do feel sorry for my colleagues that do see Medicare patients, because they are going to be hit with a tsunami that is welling up right now and will hit them full force in January. There is a lot of talk bandied about currently regarding the estimated $700 billion in cuts Obamacare will make to Medicare, where it will come from, who it will affect. In a move likely designed to reassure nervous seniors about the status of their healthcare, the administration has stated that the majority of the cuts are meant to decrease payments to physicians and hospitals; that they wouldn’t think of cutting anybody’s benefits. This is the type of reassurance that Wile E. Coyote gave the Roadrunner just prior to the anvil dropping from the sky,

 or that given by Snidely Whiplash to Nell just before tying her to the railroad tracks.

 

This stance begs a very fundamental question. What does the administration think that Medicare benefits are made of, if not mostly payments to physicians and hospitals? If you think it is hard to find a doc who accepts Medicare now, just wait until they see a 31% cut in January.  If we can’t have a substantive conversation about the sustainability or the viability of Medicare without resorting to silly assertions such as the above, then this debate needs more than an astute politician to turn the tide. It will take a hero the like we haven’t seen in a long while:

The administration’s thinking on the Medicare cut issue is almost sophomoric. Cartoonlike comes to mind.

 

Dr. K

Tuberculosis and how the West was won...

Tuberculosis has been around for a great while.  It was one of the scourges of mankind and has the potential to still be so, with the resurgence of multi-drug resistant strains of the germ.  It has had an effect on much of history, and Arizona’s history is no different.

A young man from Georgia, a graduate of the Pennsylvania College of Dental Surgery, attempted to ply his trade in his home state, but contracted tuberculosis so he set out to practice in Dallas, Texas.  His efforts met with little success, as he found it difficult to keep patients due to his constant cough.  He did, however, discover that a knack for gambling more than made up for his loss of patients, and he devoted most of the rest of his short life to this latter pursuit.  His gambling prowess took him all over the Southwest, from Cheyenne to Dodge City, from Denver to Deadwood, and from Denison to Las Vegas.  He was involved in many a barroom fight and a number of shootings and stabbings, but ended up dying from his consumption at the age of 36 in Glenwood Springs, Colorado.

The Arizona part of this story?  Well, he happened to befriend some brothers who requested his presence in a small southeastern Arizona town that was undergoing a silver mining boom at the time.  These brothers were involved in an imbroglio with a gang of cowboys and needed the abilities of our intrepid dentist.  He did show up and things were settled, after a fashion.  The resulting uproar eventually led to his flight to the state of Colorado where he spent the remainder of his short days.

We are left to ponder what might have happened to the history books if adequate treatments for tuberculosis had been available for our young tooth puller.  Why, he might have remained in Georgia, set up practice, raised a family and died at the ripe old age of 86 for all we know.  But there were no effective treatments for his disease.  It wasn’t even known to be contagious until the 1880’s.  And our dentist friend was born in 1851.  He passed away in 1887.  Medicine’s progress came too late for him. 

It also came too late for Tom and Frank McLaury, as well as Billy Clanton.  All three were killed in a town called Tombstone in the Arizona Territory, during the fight at the O.K. Corral.  Involved in the gunfight were the Earp brothers and their friend- John Henry Holliday, who was present that day only because of his untreatable tuberculosis.   Since he was a dentist, you probably know him better as “Doc”. 

 

 

"Doc" Holliday.

 

Dr. K