Sunday, November 18, 2007


I challenge you, Stephen Colbert! You are not a true American!

America, we’ve been duped. Stephen Colbert is not who he claims to be (he may actually be an automaton from the future who’s trying to dupe us). He’d have you believe that he’s some right-wing fanatic when, in reality, he’s only a right-beak or maybe a foot. And I can prove it!

From chapter one of his book, I AM AMERICA (AND SO CAN YOU!), his family values seem admirable but fail to go the distance (got your boxing gloves on, Colbert?) He only hints at the disease that is homosexuality (i.e., Hollywood gaydom). I mean, these individuals (do not call them people!) are doctors, lawyers, judges, and porno store owners. We need to step back a few decades and purge these people (gah!) from our communities. Does Colbert say this? No! Shame on you, Steven (I’ve removed the "ph" from your name and put in the standard "v" for "victory" which is much more American and saves text space. Should you decide to reprint your book, Ste"v"en, you can send me a check for the amount of page space I saved the printer).

The left-wing liberal media is destroying our country but Colbert, again, doesn’t step up and hit a home run (baseball references are very American, too). Nowhere does he mention the need to shut down these outlets, only to try and help them change venues. I say no! We need to get rid of these newspapers, magazines, and other forms of knowledge. Does he ever say that ignorance is bliss? Again, no! If God had wanted us to have knowledge, he wouldn’t have gotten so miffed at Adam and Even when they ate from the darned tree! (Note to self. "Miffed at Adam and Eve" to be new chapter included in next bible reprinting. Start writing now!)

Religion. Oh boy, Steven. You really missed the boat on this one. Our forefathers (there were only four?) who, ironically, came over on a boat, helped spearhead the way for Christianity in the U.S. by helping the Native Americans turn to Jesus. We also helped them build up their immunity by giving them small-pox blankets and showing them close-ups of lead-filled musket balls. Spreading the word of Jesus went hand-in-hand with the spread of disease (and lead). White man’s disease, that is (syphilis comes later, too, but is icky to talk about). Colbert fails to mention this. Poor sap.

And I have to mention Steven’s last name and his lame (and misguided) attempts to get Chevron to sponsor portions of his book. Steven, your last name is Colbert. Has a certain "energy" ring to it, doesn’t it? And it isn’t "gasoline." Colbert. Coal-bert. Get it! You should be showing Americans the dangers of alternative fuels by supporting the coal industry, Coalbert. Wind and solar power? You can’t even see them! How can you trust something that hides from you and produces no greenhouse gasses? I mean, come on!

Also my attorneys will be contacting you, Steven Coalbert, because there wasn’t sufficient warning regarding putting this book down slowly and, like you, I injured my wrist in doing so. You can avoid any nasty and lengthy court trials, if you’d like, by sending me a check for $1 billion to: The

Sunday, November 11, 2007


What can medicine do to improve the quality of patient care around the world? That is, at its heart, the question that author Atul Gawande throws at readers and practitioners alike. "We can do better," he tells us, and thus begat the title: BETTER.

Having thoroughly enjoyed Complications, I decided to check out Dr. Gawande's other writings and was pleasantly surprised to find this collection of stories. Although both Complications and Better are short story compilations,
lacked cohesiveness whereas Better had no such problems.

Leading us down simple and often shocking paths, Gawande gives us complicated facts but in laymen's terms. The simplest would be his chapter on hand washing, and how effective it can be for preventing the spread of infection, especially such newly dangerous things as MRSA, an antibiotic resistant bacterial strain that is killing hospital patients far too often. The ease with which its spread is preventable is as simple as a hand cleanser, yet getting doctors (and other medical staff) to do this is nearly impossible. "We can do better."

The beleaguered medical malpractice insurance requirements that plague every doctors pocketbook is hit hard upon, including a look at why it is necessary and why the system is headed for deep trouble. "We can do better."

Probably the most telling chapters were directed at Dr. Gawande's return to India (his national homeland). Polio is on the run and is nearly extinct as a disease. Yet in small Indian provinces, occasional "hot spots" flare up and a band of less than 10 medical men and women must vaccinate over 4 million children in less than two weeks. And they do it. Gawande tells us if this is possible, can't the U.S. do better at fighting infection? The other striking aspect is how India's doctors often work with substandard supplies (or minimal) on dangerous cases. Or perform a surgery they've never done before or are ill equipped to handle. But handle it they do. One such case involved a boy with hydrocephalus ("water on the brain" caused by a build up of cerebral spinal fluid). No physicians at the hospital Gawande visited had ever done a shunt, the procedure necessary to relieve the pressure. But they eventually do a makeshift surgery that saves the boys life "using about as few supplies as I'd use for a suture repair." Quite an eye-opener. "We can do better."

The chapters on CF (cystic fibrosis) are exceptionally well rendered as we learn that doing better at one thing can have huge benefits. When physicians focus all of their talents on cystic fibrosis, the result was astounding. Life expectancy for CF patients jumped from 17 years of age to over 40. And now it looks like they may very well be able to live into the 70s. It isn't some new super-drug that's extending these peoples lives, but looking at the disease process in terms of better treatment strategies; living proof that doing "Better" can help medicine achieve miraculous results.

Atul Gawande is to be commended for writing a book that flays open the medical system and exposes the diseases beneath; diseases that we can do better at.