7/1/08
You can't deny this isn't an interesting time to be an American. I never use a national holiday to think much about anything other than planning my distractions, but this Friday seems to fall during a particularly charged moment. In 1914, Louis Brandeis said "Publicity is justly commended as a remedy for social and industrial diseases. Sunlight is said to be the best of disinfectants; electric light the most efficient policeman."
In the same vein, I'd like to publish a few of my worries today – nothing personal, only global. Maybe I can look back on them someday and consider myself either clairvoyant or hysterical. Or vaguely boring; I don't pretend to have a stranglehold on historical drama. Either way, here they are:
- I'm worried Obama isn't who we thought he was. His statements and decisions over the last few weeks (the FISA vote, his views on the death penalty and guns, the decision to have religion playing a role in government) all read like a horror show to any of us who are remotely progressive. He's still the best candidate by a country mile, but these developments have been depressing.
- Given that the stock market and America's financial infrastructure exists largely on a crumbling gentleman's agreement, I'm worried about the Dow/NASDAQ finding a bottom lower than anyone could possibly have predicted. I'm concerned about my extended family being so heavily invested.
- The North Pole has a 50% chance of having open water this summer. Ice reflects heat; black water retains it – this has gone past science fiction and become such bad news that it all feels completely hopeless.
- I'm worried about something happening to Obama, and the Republicans managing to swipe the election. There, I said it.
- I'm concerned that a fairly simple yet audacious attack on petroleum supplies in the Middle East could push gas to just under $7 a gallon. Never mind Germany already pays $11 a gallon; we're not Germany, and this country will fundamentally change. Long-term for the better, yes, but the immediate 5-year period would be horrifying for Americans.
- I'm worried UNC will have chemistry problems with all the players we have next year, and I'm sickened by the possibility that Kobe, Lebron, etc. will actually decide to play well and win the basketball gold in Beijing, and the credit will go to Koach K.
Okay, your worries? Air 'em out here! And see you on Monday!
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i'm worried that life is becoming 80% spam.
I'm worried that my mom will get kicked out of her assisted living home because she's out of money.
I'm worried that my alcoholic father will finally drink himself to death and be found several weeks later in his squalid apartment.
I'm worried that spammers will start ruining the comments section of Xtcian. (see first comment!)
More seriously, I am worried about how we'll live comfortably in retirement. Health care costs are a big part of my concern, but the cost of living in New England is another challenge -- particularly housing.
Mary/Bozoette: So sorry you're having this anxiety about your mom's situation. You are not alone. In this country, working people with small children and middle-agers with very elderly parents get smacked with the same tough-shit, you're-on-your-own wet towel in our societal locker room.
I am worried that they might close Time Out in Chapel Hill. The University just bought the square and new management might just want to "upgrade" the place.
Ian, didn't you coin the description of the Chicken, Egg, and Cheese biscuit as "The Cholesterol Bong"
i'm worried that these babies will never come out. i am worried that when they do, it will hurt. or i am worried that i won't feel a thing because I'll have to have a c-section. i am worried about being responsible for two new little human beings.... i could go on, but i won't. xx
I am worried that all the beautiful women out there will continue to view me as merely a piece of meat or conquest rather than someone who could be their friend.
Jif, a couple summers ago I was on bed rest awaiting the arrival of my b/g twins and worried about all the same things, including will I hang on to at least 34 weeks, and will I be able to nurse and bottle feed both? (YES.. thanks largely to this :http://www.twins2feed.com/index.html)
That first year was a blur.. now the worries include potty training one and insulin injections for the other one, but life with twins has been intense and such fun. Eat much and take care :)
Ian - I agree with your entire post! Mark the date. :) My husband is in finance and we talk about the state of the economy a lot... it's really scary. I worry that we will go into a near-depression (and I think we will). I worry that we will lose our jobs and have to move away from NYC. I worry about the climate and I worry about why people still just don't fucking get it.
I'm worried that I won't get tickets to hear Kevin Costner and his band play tomorrow night at the Durham Bulls ballpark. No seriously. Quit laughing.
But Salem's Little Sister, there are LOTS of tickets left. I just checked for ya... Why the worry, buddy??
Seriously, Kevin Costner has a band?
ok, cool enough
enjoy the show
i worry that i worry about things i can't control as a way of avoiding dealing with the things i can.
so i worry about obama losing the faith of his base. and i also worry about something happening in the election that causes the republicans to win and i worry that those in the current administration who have committed crimes will never be made accountable.
i probably should be worrying more about getting the apartment in shape for a baby.
I worry that I am not thankful enough for the wonderful opportunities that I have been given and for the overall wonderful life that I have.
I also worry that my son will never understand how different his childhood will be from mine, and how profoundly different his will be from his grandparents.
I'm also worried that I broke something from laughing so hard as SlS's comment - it wasn't really funny until the "Quit laughing."
This is the first time I have blogged on this site, but have been a "stalker" for years now. I worry that my kids won't have the opportunities that I had (like go out of state to go to a great college in Chapel Hill), that they won't have the same freedoms we have now b/c it will be either too expensive, not available, or just so impractical. I also worry that they won't be able to do what they ending up falling in love with b/c they will be so worried about how they will afford "life." I worry that we have fallen into a financial chasm so deep, that the people who could get us out of it, can't even if they tried and that we will be the victims of our own successes. I worry that we should be asking others for help but b/c of bad history with words and actions towards others, that our ask for help (were we ever to take on that humility) will fall on deaf ears.
I"ll say it--It's not un-American to anticipate 'getting behind' some of these other national teams, especially against the Americans, if all for the camaraderie and collective of the game. Hell, I even rooted for Kobe to make it more respectable against the dominant Celts. The Olympics is a summer basketball highlight and I'm assuming gym air will be less grim air in Beijing and the USA will thrive, but I'm also way over getting robbed by the Russians way back when I was in grade school and never had much empathy at all for any moments we've recently been embarrassed on the internat'l stage, regardless of the roster. Oh yeah, and it's fun to watch rat-face squirm. There, it's off my chest. Thanx Ian.
I'm extremely worried about the future of primary care medicine in his country> I think people deserve quality health care and I enjoy giving it but it is getting harder and harder to do that for people. Demand is very high but sustainability is challenging and burn out is hard to avoid. 10% Medicare cuts are looming and costs of providing care are increasing. The choice will be to stop taking insurance or quit private practice entirely both of which are disappointing to me. I just want to provide good care and make as much as my plumber does. Too much to ask?
Now how am I supposed to sleep??
Julie, welcome and please keep commenting! Then some of us who comment a lot won't look as much like big hogs.
I'm worried that I will get sunburned on the beach today. I'm worried that the Yankees might actually miss the playoffs for the first time since I was in college. I'm worried that the pulled muscle in my rib cage won't heal up in time to play Merion next Friday. I'm worried that the liquor store won't have a bottle of Macallan 12 today, and I'm almost out (I still can't believe that there wasn't a bottle of Macallan in that scotch picture the other week). I'm worried that caveman might someday lose that outstanding sense of humor. I'm worried that being on vacation all week has made me lose sight of the things that I should really be worried about.
I worry that I will spend the rest of my life falling farther and farther behind on my family's medical bills, and will never get to retire or do something luxurious.
Now I'm worried about a million more things than I was yesterday!
I'm too busy to worry about anything. Fuck worrying, just get up and dance.
Neva, I read an article somewhere-- can't recall just now but I'll look for it--that explained how tort reform in Texas has been so wildly successful that doctors are flooding the state and trial lawyers are fleeing like rats from a sinking ship. There are so many new applications that the state board is hopelessly behind in processing them and the legislated approved funds to hire dozens of people specifically for that purpose. Apparently, the increase has been occuring across all specialties, but most notably among ones that previously had the highest risk of lawsuits. The credit the change to the dramatic drop in insurance costs, which have made medicine much more profitable for physicians, and there have been other unanticipated benefits as well. It's certainly a model worth looking at for the rest of the states.
I'm still worried that obama is a great orator and just another politician. i hope all his manic supporters hold his feet to the fire cause he has abandoned a large part of those that took him on his word about 'change'. This month i seems his idea of change is to "change" his position on many key ideas he ran on in the primary.
Separation of church and state ( hey lets funnel public money to churches) standing up to special interests( hello NRA), protecting our civl rights and defending our right to privacy (wire tapping anyone?).
So much for change.
If this past month is any indication of his idea of leadership in the coming months, then I am worried for this country.
Still thinking i might write in Hillary's name in november.
Thanks Matt. Not sure you're still reading, but I get your point. Unfortunately, it's not that simple. I see malpractice as only one small bit player in this drama. NC actually has decent malpractice rates and I even get a 50% discount b/c I'm part time. So, I can't blame malpractice as the culprit. Is there a defensiveness and paranoia to medical practice though, absolutely, but it contributes more to the endless testing, spending, and prescribing that goes on. That's only the tip of the iceberg though. Malpractice is much more of a problem for people who do procedures (surgeons, etc.) than us lowly primary care docs.
For outpatient primary care, I see insurers as a bigger problem. Imagine selling someone a bill of goods not knowing when or if you'll ever get paid for if. If you do get paid it may be weeks or months from now and take up a huge amount of your staff time to get that 60$ you're owed from Aetna/Cigna/Medicare etc.
Also, as opposed to lawyers who are paid for telephone time, email time, advice/help/consults, we doctors are supposed to just "be available" for free for this sort of thing endlessly even if we never see a dime from the patient's insurer or they haven't stepped foot in our office for 6 months. It makes for burned out, frustrated doctors who have lost their sense of compassion and interest in people and can't wait to do something else. No one is going into primary care anymore and I don't blame them.
It's a system that is broken for patients and doctors and we'd all be better off with something different.
I think I understand your point, Neva, and it makes me even more appreciative of my own PCP, who called me at home several times the other week on her own dime to check up on me and discuss my recent MRI (3 ruptured discs). She could've had me make another office visit, but she explained the findings over the phone and called in my scripts. She's always available, as you say, and destined for burn out, I guess. Still, I think you've discounted the effect tort reform has had on improving access to all types of medical care. I've seen a number of special_ists lately (orthopedic to nuerologist to nuerosurgeon) and took the opportunity to ask their opinions on the subject, as it interests me (my wife is a pediatrician). They all favored tort reform and believed it would help, even if it doesn't fix all the problems associated with patient insurance.
You have a unique doctor Matt. I am much the same way as a physician (calling my patients, giving out advice free, etc.) but most of us can't keep it up forever before we start to feel used or put upon or just unappreciated by this nightmarish system. Not to mention the extra time it takes away from family and life in general to do that extra medical care.
I think all doctors would appreciate and love to see tort reform (especially surgeons) but I would like to see reform of the insurance industry too.
Just today I heard from a friend in practice that BCBS is now asking for over $100,000 back on claims they've now decided 5 years later that they don't think were reasonable to have paid him on. Of course he's getting a lawyer to fight that but that'll be costly too. They have us by the balls and their job is to deny care if they can. And, if they can't do that, then make it so difficult to get paid that we pull our hair out trying to practice medicine.
I'm worried that some lefties, apparently unaware that the enemy of good is better, will find Obama to be less than perfect and use that discovery as an excuse to stay home on election day, or to vote for some third-party candidate who has less chance of getting elected than I do.
Al Gore was found to be less than perfectly progressive in 2000 and, boy, we sure showed him.