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Medical Career Education Choices Evaluate Desirability Demographics

0604 -
0604 -    ..
0605 - Summary/Objective
0606 -
060601 - Follow up ref SDS 3 0000. ref SDS 2 0000.
060602 -
060603 - Submitted ref DIT 1 0001 to Ross responding to his letter a few days
060604 - ago, ref DRP 2 0001, received on 041018. ref SDS 3 0001
060605 -
060606 -    1.  Really pleased to hear Stu is following big brother's lead and
060607 -        doing well in sports and academics. ref DIT 1 0001
060609 -         ..
060610 -    2.  Maybe Hutch saw "The Fugitive" that has been on HBO quite a few
060611 -        times the past number of months, and that tipped the balance
060612 -        toward declaring pre-med. ref DIT 1 XV6F
060614 -  ..
060615 - Another cultural incentive toward a medical career is the movie
060616 - "Something the Lord Made" that chronicles the lives of famous
060617 - researchers, and illustrates successful collaboration solving
060618 - difficult challenges, including social change.
060620 -  ..
060621 - Letter to Ross continues...
060622 -
060623 -    3.  You and Claudia running.  I have noticed there seems to be a
060624 -        transition at about age 50+ where suddenly the girls are doing
060625 -        a lot more working out than the guys.  Something to think about
060626 -        down the road. ref DIT 1 W86K
060628 -         ..
060629 -    4.  This past April, when Millie got the news about misdiagnosis in
060630 -        her case, and so she had to go back into treatment, we started
060631 -        walking (yes walking) around Lafayette Reservoir.  Mil has been
060632 -        working out for years at the gym and hiking up Mt. Diablo, etc,
060633 -        while I am "working out" on the computer.  So, when we started
060634 -        in April, she beat me handily over the 3 mile course around the
060635 -        reservoir.  In fact, I was dying the first few times we went
060636 -        out, but forced myself, because exercise is good for Mil's
060637 -        immune system, and she likes doing this with someone, and none
060638 -        of her girl friends can keep up with her.  That was before the
060639 -        new disease really took hold. ref DIT 1 F97G
060640 -
060641 -            [On 041028 Ross cites Millie in a letter to his son,
060642 -            Hutch. ref SDS 5 QX7M
060644 -         ..
060645 -    5.  Over the next few months into July, I got better, and we
060646 -        started doing 7 mile walks around town 4 - 5 times a week.  I
060647 -        was beginning to think about running again.  Mil got some
060648 -        Glucosomine Chronroiten that helped the knee problem (could
060649 -        help your ankles). We even talked about calling you to hike
060650 -        Yosemite falls, maybe finish that trek up Half Dome.
060651 -        ref DIT 1 Y98J
060653 -         ..
060654 -    6.  In early July, after a few cycles of chemo, we were nearing the
060655 -        end of a hike, and Millie suddenly said, "Hey I'm tired. Can we
060656 -        slow down." ref DIT 1 T99H
060658 -         ..
060659 -    7.  I have never heard her say "Can we slow down," so it was a
060660 -        shock.  That ended our hiking.  Chemo builds up and saps the
060661 -        energy.  The good news is we have hiked the reservoir a few
060662 -        times lately, and she has done well. ref DIT 1 649M
060664 -         ..
060665 -    8.  Last week we went for a 2nd opinion to UCSF, and then to
060666 -        Stanford the next day, and it does not look good for Millie to
060667 -        get off treatment, which is necessary for energy to get back to
060668 -        normal. Right now she is stable, no express evidence of
060669 -        disease, but the opinions are that disease is there and is
060670 -        gathering strength to defeat the current treatment, so its just
060671 -        a matter of time. Maybe lightening will strike. ref DIT 1 U44I
060673 -         ..
060674 -    9.  The worse news, which has not really been presented to Mil is
060675 -        that delayed treatment for about 18 months in her case
060676 -        increases the rate of morbidity. Nobody wants to tell the
060677 -        patient bad news.  Once we get the written opinions from UCSF
060678 -        and Stanford, the guys at Kaiser will have to address it.
060679 -        ref DIT 1 E55H
060681 -         ..
060682 -   10.  This all impacts Hutch in the following way. ref DIT 1 O55O
060684 -         ..
060685 -   11.  Medical practice is essentially a "rat race."  You may think:
060686 -        "Hey, so is lending money, mowing lawns, or anything else,"
060687 -        but, in medicine, daily bumbling causes a lot of pain and death
060688 -        that impacts both patient and practitioner.  We see this in the
060689 -        chemo clinic where staff are tending a lot of patients, and
060690 -        continually overlook little details.
060691 -
060692 -            [041028 Ross cites this analysis in a letter to Hutch.
060693 -            ref SDS 5 QY5J
060695 -         ..
060696 -   12.  Last week the nurse forgot to give Mil one of the infusion
060697 -        treatments, then started crying when this was mentioned,
060698 -        because the sequence of tasks conflicted with the record of
060699 -        prior treatments, reported on 041021. ref SDS 4 NG7B  Most of
060700 -        these little mistakes are forgotten in the "fog of war" (see
060701 -        NWO, ref OF 11 159O), especially if the patient seems not to
060702 -        suffer.  If the patient suffers later from erroneous treatment,
060703 -        then delay between the original cause and the date when pain is
060704 -        experienced prevents accountability, so everybody just shrugs
060705 -        and goes on to the next patient.  Public reporting on 990912
060706 -        underscores challenges doctors and patients face in struggling
060707 -        to avoid calamitous errors due to the the complexities of
060708 -        medical practice. ref SDS 1 0001
060710 -         ..
060711 -   13.  The point is that health care is stressful, and this stress is
060712 -        on a collision course with rising demographics and improving
060713 -        technology. ref DIT 1 I66H
060715 -         ..
060716 -   14.  We are only at the tip of the ice berg on the ratio of doctors
060717 -        to patients, and especially to elderly patients who need the
060718 -        most care.  The better we get at prolonging life, the bigger
060719 -        the problem.  It's a Malthusian dilemma. Over the next 20
060720 -        years, when Hutch hits the middle of his career, health care
060721 -        will be overwhelmed by the glut of baby boomers going through
060722 -        the system; that's me at one end, and you at the other.  The
060723 -        current pandemic of bumbling, frustration, loss, crisis, and
060724 -        daily calamity reported on 990912 is escalating.  In one sense
060725 -        we need a lot more Hutches, i.e., the core problem will be a
060726 -        shortage of doctors and nurses.  But, from Hutch's perspective,
060727 -        it is not likely this demand will be met, and so he will be in
060728 -        a situation that will seem even more hopeless than today, with
060729 -        attendant stress and psychosis.  Obviously, some folks won't
060730 -        care - saying to themselves, "Do what you can, then go home and
060731 -        watch television, work on the boat, whatever." ref DIT 1 PE3N
060733 -         ..
060734 -   15.  Enough on this negative stuff. ref DIT 1 1F5L
060736 -         ..
060737 -   16.  Right now we are celebrating Mil's return to work, and evident
060738 -        disease free condition for about the past month or so.  We also
060739 -        got word today of a 4 to 1 vote approving the next step toward
060740 -        whatever they are doing with SDS at Boeing.  Can miracles still
060741 -        happen?  Yes -- the cost of servicing the car today was only
060742 -        $37 against an estimate of $95, and the Red Sox swept the
060743 -        Cardinals. That makes up a bit for the Yankees blowing a 3 0
060744 -        lead on Boston last week.  Hopefully, Steinbrenner will get
060745 -        some pitching for next year.  If Bush wins his vote next week
060746 -        things will sound really great. ref DIT 1 FF5O
060748 -         ..
060749 -   17.  On that SDS record, changed IBM to "the company."  Let me know,
060750 -        if you see anything else you want changed. ref DIT 1 00W2
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