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Friday, June 25, 2004

News from the Beaver Front: OSU Engineers Develop Portable Kidney Dialysis Machines

Engineers from Oregon State University in connection with a Portland research firm have developed a microtechnology that will allow for the development of portable kidney dialysis machines. This technology will allow dialysis patients to have greater flexibility--patients will no longer have to center their schedules around lengthy dialysis treatments, some of which can last up to 5 hours. Portable kidney dialysis machines would also allow for in-home treatment, with the potential for patients to dialyze while asleep. Efficiency of dialysis is also predicted to increase, increasing efficiency from 28% (efficiency with current dialysis machines) to 90%.

This is big news for dialysis patients and their families! :)

Go Beavs!


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Medicare's New Prescription Benefit Plan: A Lottery Approach

From today's edition of the USA Today: In 2006 a new prescription benefit plan under Medicare will come into effect. HHSS Tommy Thompson predicts 500,000 to 600,000 individuals will benefit from the plan which will cover medications for cancer and other diseases. Bush has decided to have a lottery for 50,000 people to win a chance for this coverage now before the plan comes into effect--where half of the recipients will be cancer patients. You submit your application to Medicare and hope for the best.

Reading this article evoked mixed feelings. On the one hand, hearing about the new prescription benefit plan under Medicare is good. For all the talk that Supreme Court Justices do in the context of end of life refusal of care cases regarding the state's interest in maintaining the life of its citizens, and maintaining a healthy citizenry, the government is making a step in the right direction to reinforce such a commitment. But on the other hand, the lottery plan seems inherently unjust in a sense other than the obvious. Above and beyond the fact that only a very few of the most disadvantaged will be able to (at least initially) take advantage of the prescription drug benefit plan as opposed to most or even all of those who need it, there is something more that makes this lottery plan unjust--something perhaps that is so egregious so that the good that does come from offering 50,000 people coverage does not justify the lottery plan. And I am troubled that I cannot put my finger on what that is--that is, what makes this situation especially unjust. This is bothering me...any ideas?
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Thursday, June 24, 2004

Bill Clinton's My Life
The Washington Post, The New York Times, The Salt Lake Tribune, and USA Today (just to name a few) is reporting record sales of Bill Clinton's memoir, My Life. Are the record sales due to our overwhelming curiosity to know the intimate details of Clinton's sex scandals? And what could he possibly say that could take up 957 pages?!
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Wednesday, June 23, 2004

Portland Police Have a Lead on the BYU Case
Today on the radio it was announced that Portland police have a lead on the BYU student who was visiting family in Corvallis, OR and went missing. I am not clear whether they have charged this individual with anything yet, but the only evidence they have against him is that he has a history of stealing women's underwear--women who are undergrads at Oregon colleges and universities. What makes this count as evidence against him?
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Tuesday, June 22, 2004

What Makes a Romantic Comedy Good?
...some of my friends (those with more "sophisticated" tastes in movies) may disagree with the spirit of this post altogether and claim that there is no such thing as a good romantic comedy. I disagree wholeheartedly! But as much as I am a sucker for romantic comedies (and pretty much any romantic comedy will do) I have recently discovered that my taste for romantic comedies might be a little more discriminating than I once thought. Several weeks ago a friend and I went to see "The Prince and Me," starring Julia Stiles. (Read no further if you do not want the ending spoiled.) Stiles is a senior at a college in Wisconsin who dreams of attending med school at Hopkins, and during her senior year she meets and falls in love with Prince Edward, the Prince of Denmark (who has, by the way, posted on my blog). Of course, she falls in love with him not knowing who he is. Prince Edward goes to the states because he is tired of the royal life, and he too falls in love with Stiles. After some back and forth, they end up together, Edward assumes the throne and Stiles will become queen of Denmark.

Now, as far as romantic comedies go, I was disappointed by this one because it was too much like a fairy tale as opposed to a realistic story of requited love. I am satisfied with a romantic comedy that presents a realistic story of requited love, so that when I walk out of the movies I am instilled with a new optimism that maybe it will happen to me, too--the requited love part, that is. Though maybe I am wrong to criticize romantic comedies like "The Prince and Me" on the point of it not being realistic enough. Perhaps given the nature of love, and that it rarely is requited, we can expect no more from a romantic comedy than a fairy-tale like portrait of requited love since instances of this in real life are rare.
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More on Wanting Our Physicians to Care
A while back I posted on whether we want our doctors to care, or whether we would choose competence over a doctor who shows compassion, supposing in some cases cutting-edge specialists might not exhibit compassion to avoid burn out from emotional engagement with their patients.

In a conversation with a friend over this topic, I think that I might have said at the time that I wanted a doctor who was competent over one who was compassionate. My experience this weekend changed my mind. Someone who I went to college with unexpectedly came into Salt Lake and crashed at my place as his plane was re-routed due to thunder storms in Salt Lake. He is just starting his residency in emergency medicine, having just finished med school at U-Penn. Maybe it is because I do bioethics where I regularly interact with docs that I am especially sensitive to physicians who are arrogant. But his attitude was such that I was certain by the end of his visit, I would choose the compassionate doc. What is more, is that I would trust the compassionate doc more than I would the doc who might have a slightly better track record than the caring doc, especially when it comes to some surgical procedure. As I write this, this seems completely counter-intuitive, but I think there is something to be said about entrusting your life to someone who (at the very least) seems to care. Any thoughts?
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Monday, June 14, 2004

Medical Malpractice Lawyers Get Denied Care
It has been recently been brought to my attention, via a front page article featured in USA Today, that medical malpractice lawyers usually face difficulty getting medical care when needed, except in cases of medical emergency. The argument for refusing them care seems to be that they spear-head medical malpractice lawsuits many of which are frivolous, and have skyrocketed the costs of malpractice insurance. Physicians are trying to get the support of the AMA to back this policy, and some argue that this measure is not only necessary but justified because physicians are not required to care for just any patient that requests care (except in emergencies). On the other side of the debate are people who argue that such a practice would violate the ethic outlined in the Hippocratic Oath. Not only have medical malpractice lawyers blacklisted and typically denied care, but so are spouses as well as lawyers whose specialty is not medical malpractice. And most recently, a nurse from Good Shepherd Medical Center (Longview, TX) was fired from her position because her husband is a lawyer whose firm specializes in medical malpractice though he himself does not participate in medical malpractice litigation! Unbelievable! I think this is completely outrageous, and reading these kinds of stories (as well as personal experience with lack of health coverage as a grad student) makes it difficult for me to teach my undergrad bioethics class on issues having to do with the government having an interest in a healthy citizenry, which has been a core value at stake in many court cases, especially those involving parents who deny life-saving treatment for their child. How can the government have an interest in the health of its citizens if the citizens don't care?
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Sunday, June 13, 2004

Lucky Charms
I must be having a Seinfeld moment, or maybe I should say a Costanza moment because I was fascinated by my bowl of Lucky Charms. The marshmallows are now bigger than the used to be. Why is that? And am I just imagining this?
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Thursday, June 10, 2004

More Proof that Dogs are Better than Cats
...with the exception of some cats, of course. Check out this story from today's edition of USA today--you can access the article at http://www.usatoday.com/news/science/2004-06-10-dogs-language_x.htm. Researchers find that some dogs (here they have a Border Collie) can understand up to 200 words.
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Health Insurance
For the first time since I have been a graduate student at the University of Utah, the graduate school is offering its TA's and RA's health insurance, something that many graduate schools already offer. For those of us who will be on fellowship, while the word is not yet final, it looks like (more than likely) we will not have health insurance covered for us by the graduate school. I left a message for an official at the graduate school who might be able to explain what their policy will be regarding health care coverage for fellows, and I have yet to hear from her...What do you think?
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Wednesday, June 09, 2004

Movie Heaven
My taste in movies markedly differs from that of my friends. I am a sucker for romantic comedies, as some of you may know. And if I do get to watch a romantic comedy with my friends, it is usually just because they owe me--that is, I have sat through one of their movies (usually one that involves some complex, convoluted, non-romantic plot). Tonite I am in movie heaven--I am watching "The Wedding Singer" on TBS and "Sleepless in Seattle" is on next, though I do have to agree with a friend who recently told me that movies like "Sleepless in Seattle" ought to come with warning labels for those of us who might be especially sensitive. Back to the show... :)
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Tuesday, June 08, 2004

Do we want our teachers to care?
I recently posted about whether it is we want our doctors to care, and whether we would choose compassion over competence, should the competent physician of our choosing not be compassionate. I want to ask a similar question now that came to mind after meeting with a student of mine. We both attended the same undergrad (Oregon State University) and both had a certain professor (who shall remain nameless at least for the time being) for general chemistry. Aside from not caring about the welfare of his students insofar as they walked away with a satifactory grasp of chemistry coming out of his class, he was outright rude to his students. He has since been dismissed from teaching undergraduate general chemistry, which I am sure is beneficial for everyone involved. This man is a brilliant chemist, definitely the type to be kept in the lab and away from students--his professional competence as a chemist is not at issue (in the slightest). But sharing my frustration regarding the experience I had in his class with this other person who is now a student of mine, made me wonder whether we want or expect our teachers to care. Does this make them better teachers in our eyes, if they care? Or at least give a convincing show that they do care? I think this makes the difference for me. Any thoughts on this?
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Monday, June 07, 2004

Fellow Bloggers Beware!
Jessica Cutler, an aide to Mike DeWine (R, OH), recently published her sexual escapades with more than one official from DC. Playboy has since cut her a deal. Seems like Monica Lewinsky is behind the times. A question for my fellow bloggers--what, if any protection, does the first ammendment offer bloggers?



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Ronald Reagan
It was certainly sad to hear of Ronald Reagan's passing this weekend, especially given his condition. His death made me return to a question that I often ask myself while watching news coverage on the death of someone famous--do the lives of people who die become more noteworthy than they were when they were alive? And if they do, why?
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Thursday, June 03, 2004

Do we want our doctors to care?
A friend recently posted on his blog a conversation we recently had about whether people want their doctors to care, or whether all that matters is that a physician is competent. Since this issue is something I am currently working on, I thought blogging on it would be a good idea. In "From Detached Concern to Empathy" (which, BTW, I am not done reading yet since I am not a speed reader--my inability to speed read is probably somehow linked to my inept GRE taking ability!) Jodi Halpern argues that physicians should move away from the currently accepted model of detached concern. On this current model, to avoid burn-out that may result from becoming emotionally invested in one's patients, doctors should care for the well-being of their patients (and we expect as much) while still remaining professionally distanced. Halpern argues that patients would benefit therapeutically if physicians strive to develop an empathetic connection with their patients. My view is that this is impossible given the nature of empathy. At best, physicians can only develop a genuine sympathetic or compassionate connection with their patients which would seem to do the positive work that Halpern expects of empathy. As I understand empathy (roughly, a kind of emotional identification with another person) a necessary though not sufficient condition for empathy is that one person has experienced whatever a second person is experiencing. For example, to empathize with a breast cancer survivor, one has to have had direct experience with breast cancer. Otherwise, all you can do is establish a sympathetic connection with the breast cancer survivor. And sympathy gets a bad rap because sympathy can often come off as pity and no one wants that--fair enough. But in my view physicians who try to develop an empathetic connection with their patients are arrogant for thinking that they could ever know what it is like (where is Nagel when you need him) for their patient to be experiencing what they are experiencing. To me, sympathy masquarading as empathy is equivalent to a man telling me he knows what it is like to be a woman--the response I would have to such a person (besides a punch in the face) is that they should not even pretend for a moment that they know what it is like. Admitting, instead, that they do not know what it is like, while offering a sympathetic ear is what I would much rather. More on this to follow...
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Love in the Actual World?
Is love possible in the actual world? I thought about this as I watched "Love Actually" for the third time the other night. If you have not seen this movie, and you are a fan of romantic comedies, you should really see this--it is an excellent movie. And it is one that I had to watch on my own for several reasons--1) I knew I would cry and 2) my friends' tastes in movies exclude romantic comedies. Only if they owe me some favor do they allow me to watch a romantic comedy with them, and this has happened on *rare* occasions!

"Love Actually" is one of those movies that make you think about your life, and by the end of the movie you realize that your life will be markedly worse if you do not tell the one you love that you are in love with them. And this is not to say that all of the cases of love in this movie were requited, they weren't (which, sometimes is the best kind--certainly the kind I best identify with). That you should tell someone you are in love with that you are in love with them, then, is not something that should be consequentially motivated--you should not do this because you hope for a good outcome.
Chances are that the outcome won't be good--more than likely, feelings will not be mutual. The thought is that you ought to tell them for the sake of telling them. Doing this is supposed to be beneficial for two reasons: 1) you get something burdensome off your chest and 2) if you really do love them, they ought to know so that they can act as they see fit. As I see it, I think that I generally agree with these reasons for telling someone that you love them, even at the expense of looking like an incredible fool who has just served up her heart for the taking.

I think that in the best of all possible worlds that if you actually can bring yourself to tell someone that you love them, you should also be able (in the same moment) make yourself vanish...poof!

Any thoughts on this?
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