Ignorance, thy name is Obama

I'm a surgeon, a board-certified otolaryngologist who used to perform tonsillectomies, so naturally I awakened from the hypnotic slumber for a little bit during Obama's press conference last night. The man has just revealed himself as a colossal ignoramus when he was talking about that operation. First of all, most kids with sore throats are seen by pediatricians, not surgeons. The pediatrician refers children to a surgeon if he or she believes a child might benefit from surgery. There is no "kickback" for this referral possible or legal. Thereafter, the surgeon decides whether the child needs surgery, and by no means is it necessary to operate on every child thus referred. Nor is it the practice! How can Obama not know that, if he has set out to reform the entire edifice of medical care in this country? Incidentally, surgeons collect about $60 for the average tonsillectomy here in Florida. Though it is thankfully not that common, every year children die from complications of this operation, as it really is fairly major surgery. It's one of the leading causes of surgical death in children. Who wants to take on a risk like that for 60 bucks? Not me. Not exactly lining our pockets with this one, dumbass!

Mayors and Violence

Ever notice one particular political machine nearly always rules the management of the most violent cities in the U.S.?

1. St. Louis, MO: Francis G. Slay (D)

2. Detroit, MI: Kwame Kilpatrick (D)

3. Flint, MI: Don Williamson (D)

4. Compton, CA: Eric Perrodin (D)

5. Camden, NJ: Gwendolyn Faison (D)

6. Birmingham, AL: Larry Langford (D)

7. Cleveland, OH: Frank G. Jackson (D)

8. Oakland, CA: Ron Dellums (D)

9. Youngstown, OH: Jay Williams (D)

10. Gary, IN: Rudolph Clay (D)

11. Richmond, CA: Gayle McLaughlin (Green) <--- close enough

12. Baltimore, MD: Sheila Dixon (D)

13. Memphis, TN: W. W. Herenton (D)

14. Trenton, NJ: Douglas H. Palmer (D)

15. Richmond, VA: L. Douglas Wilder (D)

16. Kansas City, MO: Mark Funkhouser (D)

17. Atlanta, GA: Shirley Franklin (D)

18. Cincinnati, OH: Mark L. Mallory (D)

19. Washington, DC: Adrian Fenty (D)

20. North Charleston, SC: R. Keith Summey (R) (yes. pretty lonely on this list)

Proposed New Olympic Event: Shark Jumping

Well, first there's McCain referencing his POW experience in the Hanoi Hilton, most recently with Jay Leno.

Next, tonight's speech by Bill Clinton. Bill Clinton has definitely jumped the shark a long time ago. I am quite looking forward to what the addled old loose cannon might ad lib at tonight's DNC speech. Added Shark Jumping points if he delivers one of his interminable three-hour stream-of-consciousness rants. Judges are instructed to pay particular attention to whether his lip-biting technique has deteriorated after being on the bypass machine. Then there's the cadaveric half-open mouth showing upper teeth posture.

Finally, Obama will prove to us he is not some creepy demagogue by delivering a Nuremberg-esque rally in front of a berserk mob at Invesco Field. We can only hope he can top his psychotic "the seas began to roll back" rhetoric, although it will be difficult. Alternatively, he can address criticism about his lack of substance with a yawnworthy wonkfest of a speech, which might leave his 70,000 salivating followers scratching their heads. We will see if the cameras can be kept off the attending celebrities.

Slayer of Atwater and Kennedy

Death from Glioblastoma Multiforme is certainly not sudden, but it is inexorable. It shuts down the central nervous system as it grows, so one enters a progressively sleepy state punctuated by seizures. Along this downward course, other brain functions start to shut down: paralyzed limbs, a loss of speech. Eventually one enters the deep sleep of coma, and then death.

I'm sure Allan Friedman MD, Guy L. Odom Professor of Neurological Surgery, in the School of Medicine, Chief, Division of Neurosurgery in the Department of Surgery, Co-Director, Neuro-Oncology Program at Duke University ... I'm sure he's a capable guy, but I'm just as sure he knows he made only a gesture today. Nobody has the delusion that they can divert the juggernaut deathgrip Glioblastoma; not even, it is notable, any neurosurgeon. He must have been aware that he was participating in Kennedy myth-building. The patriarch must be seen as fighting to the last. All of the reports I'm seeing on Cablenews about "successful" surgery just indicate the patient survived surgery perhaps without new neurological deficits.

Unlike more well-behaved tumors, Glioblastoma has no definable plane between itself and normal brain tissue. Even with image-guidance, even with large margins taken around any obviously necrotic mass, macro- or microscopic tumor infiltrates and evades. After surgery, after radiation and chemotherapy, these little islands of viable tumor show up bad as ever as malignant little deathblossoms that are sadly never going to go away.

Halle FRIGGIN' luia!!!

Finally the Chicago football franchise, Bears of Little Brain, are showing something akin to horse-sense, if we can believe this.

Suffering through the Cowboys game last weekend, I couldn't get THAT mad at Rex for throwing a pick that was returned for a touchdown. The game was over by then. But the hangdog look on the face of the defense for the rest of the game was striking: their morale went down into the shitter, and the Cowgirls offensive line beat them like a red-headed mule for the rest of the game. Rex is an incompetent, and Lovie Smith's obstinate stand-by-your-man is bad for morale.

The Third Way

According to the transcript, bin Laden says there are two ways to end the war:

"The first is from our side, and it is to continue to escalate the killing and fighting against you."

The second is to do away with the American democratic system of government. "It has now become clear to you and the entire world the impotence of the democratic system and how it plays with the interests of the peoples and their blood by sacrificing soldiers and populations to achieve the interests of the major corporations."

Ah, but you are overlooking another way, Mr. bin Laden. The one where we smack you and your compadres around like a bitch for the next generation.

Maybe Michael Moore will Pick Up the Tab

He was born 11 years ago in Santiago de Cuba and had an uneventful infancy until he was 10 months old. One night the baby seemed more irritable and was clearly sick. His fever started to get worse and he began to have seizures, which frightened his mother terribly. They brought him to the local medical facility where a spinal tap confirmed that the baby had meningitis. He nearly died.

It took about a year for his family and the pediatricians to figure out that this toddler was having trouble hearing, and subsequent testing confirmed that the meningitis had deafened the boy. The only option, the family was told, was to wait until he got older, at which time he could get a cochlear implant. But when he got older, the surgeons in Cuba told his family they did not have the expertise to implant him. His cochleas had become filled with new bone and this would have to be drilled out. Somehow, a faculty member in a Public Health school in Florida became familiar with his case and began moving heaven and earth to get this child a cochlear implant.n Appeals were made via the Swiss Embassy in Cuba, in order to get a visa for offshore consultation. Then the child's chart found its way to my desk.

My gut feeling is it is too late for this boy. The surgeons in Cuba should have implanted the child when he was a baby, not "wait until he gets older". The audiologists and speech pathologists in Cuba do not have any expertise in providing the intense follow-up care and programming this child will need. The family will not be able to afford the little equipment replacement costs such as for cables and rechargeable batteries. That's if I perform the surgery, which is not likely because, a.) he's too old now, b.) patients with bone in their cochleas don't get as much benefit from implantation, c.) because of his age at deafness it is doubtful he has developed the brain connections necessary to process speech.

This boy's prospects would be a lot brighter if either a.) he were an American citizen, or b.) if the medical system in Cuba were up to snuff. We'll get the little guy a CT scan here on a REAL CT scanner and see if his cochleas really are all that bad.