Author: wellthy

I can’t believe:

• I can’t believe how our world has changed since the onset of Covid.
• I can’t believe how many people have died either directly or indirectly from Covid.
• I can’t believe people are still dying from Covid.
• I can’t believe that people still insist that Covid is not real.
• I can’t believe that people still refuse to wear a mask.
• I can’t believe that people still refuse to be vaccinated.
• I can’t believe that people are refusing simple precautions such as wearing masks and hand washing.
• I can’t believe that politicians politicized the pandemic and its treatments to win elections.
• 10.I can’t believe that people I call friends will verbally attack me for writing this article.
• I can’t believe that the cost of everything has skyrocketed.
• I can’t believe that small mom and pop businesses are closing because they can’t find the workers they need to stay open.
• I can’t believe that people believe that what they read on the internet is the gospel.
• I can’t believe that our country is coming apart at the seams.
• I can’t believe that Covid was an act of nature.
• I can’t believe that I don’t have an office to go to in the morning.
• I can’t believe I don’t have patients to care for in their times of need.
• I can’t believe that illness is slowly stripping me of everything I hold dear.
• I can’t believe that there is nothing I can do about anything!
• I can’t believe . . . .

This list can go on forever. 

There is not much I can believe.

I can believe:

• I can believe we need to be vaccinated.
• I can believe that masking may do very little to control this beast but is a fairly harmless intervention.
• I can believe that we can’t give in and let Covid run freely amongst us.
• I can believe that we can get the politics out of disease management by refusing to listen to the politicians.
• I can believe that we can stop the bickering and accusations surrounding vaccines and treatments of Covid by listening to the medical authorities and not the internet.
• I can believe that the designers of the internet use their vast powers to brainwash people.
• I can believe that we are heading for an uncivil war and it may be unstoppable at this point.
• I can believe that the political parties are as guilty as the internet, serving their own interests and not those of the people.
• I do believe that first and foremost I am a person, not a democrat and not republican. 
• We are a republic made up of people wanting to be free and prosper, not red states and blue states.
• Journalists need to report the news, not create it.  They need to pull us together, not fuel the fire.

I HAVE SPENT A LIFETIME BEING A PHYSICIAN AND HEALER.  THE FIRST STEP IN FINDING A CURE FOR WHAT AILS YOU IS TO RECOGNIZE YOU HAVE AN ILLNESS.  WE, AS A SOCIETY, HAVE A LIFE-THREATENING ILLNESS.

THE SECOND STEP IS TO FIND THE CAUSE/CAUSES.  THE ABOVE LISTS ARE ONLY THE TIP OF THE ICEBERG.  FEEL FREE TO ADD TO THIS LIST.

THE THIRD STEP IS TO DESIGN A TREATMENT COURSE.  LOOKING BACK IN HISTORY, YOU’LL FIND THAT ALL GREAT EMPIRES COME TO AN END.  I THINK OUR ILLNESS IS TERMINAL AND THAT WE ARE ON LIFESUPPORT.  I HOPE I’M WRONG.  TREATMENT ENTAILS COMING TOGETHER AS ONE AND FINDING THE TRUTH.

UNFORTUNATELY, IF I’M RIGHT, I’M GOING TO LOSE FRIENDS AND CATCH A LOT OF SHIT FROM A LOT OF PEOPLE FOR PUBLISHING THIS.

There is no joke today.  This is not a laughing matter.

Have you heard the phrase, “Live and learn?”  I’m 70 years old and can personally verify that not only is “Live and learn” true but that another common phrase, “You are never too old to learn” is true, as well.  A few weeks ago, I experienced one of life’s lessons that I wish I could have skipped.

I tore a muscle/tendon in my groin. I spent 35 years asking people to rate their pain on a 1 to 10 scale. I have had multiple docs ask me the same question.  I thought I knew what a 10 was.  I didn’t!  I was getting out of my car when I felt a burning, searing rip in my groin that almost knocked me off my feet.

When my patients complained of pain, I asked them to describe it.  I then offered them some common descriptions of pain by asking, “Is it burning, stabbing, crushing, throbbing, aching, dull, sharp, etc.?”  Once the type of pain was determined, I asked them whether it was continuous or intermittent, what made it better and what made it worse. Patients were usually quick to answer these questions and their answers made sense anatomically.

It’s when I asked them to score their pain on a 1 to 10 scale or some other scale that things got difficult. The problem with scoring your pain is that whatever scale you use, the answer is going to be highly subjective and individualized.  It is also going to be unreliable.  Scoring on a 1 to 10 scale helps the physician gage the success of his/her therapy from visit to visit.

Let me explain. Patient “A” has lower back pain.  He injured his back at work and has been out of work for        a week. He walks hunched over and rates his pain at 11 on a 10 scale. His face showed no signs of pain or distress.  His pulse and BP are normal. When my pain hit 10, my pulse shot up, I started sweating, and I screamed, “F.ck, f.ck, f.ck.”  I certainly was not calm.

So, what is a doctor to do with this patient’s 11 or 10?  Some people exaggerate (I’ve been accused of that).  If he is one who exaggerates, then his 11 will serve as his baseline and will be compared to future values. The patients 1 to 11 scale will be personalized.

Perhaps he has a low pain tolerance.  Often, I would ask the patient to imagine that he was putting up a picture and hit his thumb with the hammer rather than the nail.  I would tell him that the pain from smashing his finger should be a 10 and ask him, given that information, what his number would be.  In this case, he said 11 of 10.  He also asked for Norco.

He didn’t get his Norco and stomped out of the office.  It was interesting to note that his hunched stance disappeared as he left.  I watched him slide into the seat of his Camaro and drive off.

The point is that grading your pain based on a 1 to 10 scale is difficult and of limited value.  Categorizing pain based on the type of pain and what makes it worse or better is much more helpful.  Faking or exaggerating pain to get narcotics is not only hard to do but turns physicians into skeptics and adversely affects the care of other patients.  Abuse and overuse of narcotics has led to the current restrictions on pain management.  Many of my colleagues will no longer prescribe narcotics and many of my chronic pain patients are suffering due to these restrictions.

If you suffer from pain, before seeing your doc, assess your pain, paying attention to location, type of pain, and what improves or worsens it.  In using these descriptors, you are trying to paint a picture of your pain so that your doc can make the correct diagnosis and formulate an appropriate treatment plan.

Here’s your joke for today:

A young woman has been taking golf lessons. She has just started playing her first round of golf when she suffers a bee sting. The pain is so intense she decides to return to the clubhouse.

Her golf pro sees her come into the clubhouse and asks, “Why are you back so early? What’s wrong?”

“I was stung by a bee.”

“Where?” he asks.

“Between the first and second hole,” she replies.

He nods knowingly and says, “Apparently your stance is too wide.”

I think I’m going insane!  Retirement will do that to you.  Hour after hour, day after day, they’re all the same. Wake up, shower and dress.  Eat breakfast, take pills, and take a nap.  Eat lunch, more pills, and take a nap.  Renee asks me what I want to do.  I answer whatever you want to do.  We end up napping.  Sit outside with neighbors and drink bourbon, then there’s dinner, even more pills, some lousy TV, more naps, then sleep.  Up at 3 am and do it all over again.

What’s so fricken insane is that I counselled my patients, advising them that they could not retire until they had developed a second love that would occupy their time and stimulate their minds. Being the idiot that I am, I never developed an outside interest, immersing myself in my medical practice.  Then I got sick and had to retire.

We are too damaged to play golf or pickle ball or just about any sport.  I’d walk everyday but my groin sprain and broken toe limits my ability to walk.  I’ve bought everything I need and some things I don’t need.  On pretty days, we go cruising with the top down.  Of course, there is Rock Steady!  I’ll return when my body stops hurting.  That should occur about the time hell freezes over.

I have my first love, Renee, but I’m driving her crazy.  It’s like I’m glued to her side.  Lucky for her, she’s found some women she enjoys coffee klatsching with.

The moral of the story is to make absolutely sure you have something to do when you retire.  In essence, you need to have a second occupation and you need to start constructing it long before you reach retirement age.  Next, stay well enough to do it! Finally, be realistic!  Playing with the kids and grandchildren is not enough.  They grow up and get involved in their own worlds.  If you can, develop 2-3 interests that will keep you busy and engaged with the world around you.  You will get older; and, with age, abilities diminish.

I almost forgot to mention depression.  Depression is a normal human emotion and part the aging process.  I know it carries a stigma even though it shouldn’t.  Don’t hide from it; own it.  I remember an elderly patient who told me she was unhappy and her friends thought she was depressed.  She vehemently denied being depressed as she recounted the 7 funerals she had been to in the last 12 months.  She recounted how she lost most of her savings and was probably going to lose her house.  She told me her family had deserted her. On the third time she denied being depressed, I told her, “You’ve got two choices.  Either you can be depressed, or you are insane!  I’m depressed just listening to your story.”  She owned up to being depressed and started on meds.  The next time I saw her she was much better.

Here is today’s joke:

A woman puts an ad in the paper looking for a man who wouldn’t run away at the sight of commitment, who wouldn’t hit her, and could fulfill her sex life.

Two weeks go by and nothing. Finally, one day the doorbell rings. She opens the door and sees a no-armed, no-legged man.

She looks at him and asks, “How do you expect to fulfill my wishes?”

He explains, “I have no arms to hit you with and no legs to run away.”

Then she says, “And the sex life?” He looks at her and says, “I rang

I’m tired of living in pain as were many of my patients over the years.  The older I get, the more places I have pain.  Just when I think it can’t get any worse, it does.  I can live with the pain that comes from doing something I shouldn’t have done and hurting myself.  (There’s no cure for stupidity).  I was on prednisone and felt fantastic.  I felt like I was young again, so I tried running the track at Rock Steady without my walker.  I hit the floor hard!  I remember my head bouncing on the floor and immediate pain everywhere.          

I also remember being embarrassed. I’ve fallen before and had never felt embarrassed.  Why this time?  Because I’m a doctor and know that Parkinson’s causes patients afflicted with it to fall. I should have been more cautious. To make matters worse, while lying on the gym floor, I felt like a beached whale (I’ve lost 10 pounds and have 40 to go). Nonetheless, I did a quick check of my body, diagnosed the broken toe and declared myself healthy and ready to exercise.  That’s when my elbow swelled to the size of a baseball.  You should have seen the look on every body’s faces.  My elbow was scary looking.  I decided it was time to go home so, again acting stupid, I walked myself back to the car.

If I was my own patient, I would have read me the riot act.  I would have been self-righteous and reiterated the fact that Parkinson’s causes falls, and falls hurt!  I would have admonished myself for not using the walker and I would have wanted to ridicule myself for walking back to the car by myself.  I would have said, “I told you so. If you don’t act your age, you are going to hurt yourself.”

Luckily, I’m fine.  No, I did not drive myself home.  Renee was there and waiting for me. She wanted to take me to the ER and I refused.  Again, machismo overwrites wisdom.  Once again, I get lucky and am fine.  The moral of the story is, “Do as I say, not as I do!”  If you are at risk of falling, be careful and follow your doctor’s rules.  If you fall and hurt yourself, get checked by your doc or local ER.  If your spouse tells you he/she is worried about you, listen to your loved one!

Now, here’s your joke of the day:

Me and my girlfriend were going to a Halloween party last year and my girlfriend came down the stairs wearing nothing but boots.

I asked her, “What are you supposed to be?” She said, “Puss in boots.” So, I went into the kitchen and put a potato on my penis. When I came back out, she asked me, “What are you supposed to be?” I said, “If you can be puss in boots, then I can be a dictator

One of the most important tenets in medicine is, “Do no harm;” yet all docs realize that everything they do carries the risk of causing harm. The disconnect between the commandment, “Do no harm,” and the realization that we are always at risk of doing harm is a major cause of physicians’ daily stress and has a tremendous effect on how physicians practice medicine.

Some physicians will take a strong defensive attitude in response to their duty to do no harm.  Defending against doing harm, of being accused of harm (malpractice), often leads to a form of medical care called CYA (cover your ass) which can lead to over ordering referrals and tests, as well as under or over ordering of medications.

Others realize that there is a risk-benefit ratio for everything we do in life and become comfortable with the necessity of taking and monitoring risk while working to eradicate or alleviate suffering.  Organized medicine’s approach to solving this dilemma is to rest on the shoulders of “Informed Consent,” a document designed to spell out the risks and benefits of procedures and signed by the patient verifying that he/she has read it an understands.  Every physician eventually figures out how to live with the risk of doing harm it.

Early in my practice, I was sued by a patient I had never seen and had no relationship with.  Sounds unbelievable, doesn’t it?  That suit taught me that worrying about lawsuits and practicing CYA does no good.  I accepted the risk of practicing medicine and mitigated that risk by partnering with my patients, providing with a realistic and practical approach to caring for them.

An example will help clarify my point.  Steroids are marvelous medications effective in the treatment of many diseases.  Steroids also have the potential of causing lots of harm.  While the risk of causing diabetes is real, it is theoretical until diabetes develops and that is fairly rare.

Currently, I am on prednisone (a steroid) and I am much improved.  I probably have PMR (polymyalgia rheumatica), a disease that responds well to the long-term use of steroids.  I am so much improved that I would call my improvement miraculous.  PMR is a tough disease to diagnose but one of the diagnostic tests for PMR is to see what the effect of a low dose of prednisone is.  Again, mine is dramatic.

As I mentioned previously, the long-term risks of prednisone are many.  I’m obese, have a family history of diabetes, and at risk of developing diabetes.  Prednisone will increase that risk. I have mild hypertension.  Prednisone can adversely affect BP.  The list of risks that apply to my health is long.

Most physicians would be afraid to give me long-term prednisone for fear of causing me harm.  They shouldn’t be!  What is real is that I have Parkinson’s, chronic pain and a highly significant disability that responds well to prednisone.  What’s real is my life is much better on prednisone.

Possible side effects or harm from steroids are theoretical.  They aren’t real until they develop, and they may never develop.  As I previously stated, I partnered with my patients.  Ultimately, my patients made the decision of how much risk they were willing to accept.  Frankly, if I knew for sure that prednisone would shorten my life, I would opt to live a shorter but less painful and more mobile life.  Age has a lot to do with the decision.  At my age, I’m looking for quality, not quantity.

Too often, having heard the risks of a medicine on televised advertisements and on the internet, patients refused appropriate treatments out of fear.  They chose to live in misery now for fear of theoretical future problems.  What a pity!

Here’re a few jokes for today:

A mother complained to her consultant about her daughter’s strange eating habits.

–”All day long she lies in bed and eats yeast and car wax. What will happen to her?”

–”Eventually,” said the consultant, “she will rise and shine.”

Docs often write funny things in charts by mistake.  The following is one of my favorites: While in ER, Eva was examined, x-rated and sent home.

Well, depression finally has joined my 5 thousand other diagnoses.  If it wasn’t bad enough that Parkinson’s makes me feel like I’m drowning in quicksand, depression has just about immobilized me.  My most recent fall did more than just break my toe and bruise my elbows, it smashed my ego.  In 30 seconds, I went from feeling great on my steroids to feeling 100 years old.

Yep, I’m limping, and my body hurts everywhere.  I’m used to pain having coexisted with it for years, but the added immobility associated with the damage from the fall has been too much. Renee had been managing my depression by keeping me busy.  She’s transitioned from lover to caregiver and lover.  Unfortunately, she’s broken as well.  Her back is now as bad as mine. Getting rear ended didn’t help.

I had been managing my depression by driving around North Carolina’s country roads with the top down; but, unfortunately, someone rear-ended Renee and the car has been in the shop for months.  Damn Covid has put everything on back order and there’s no telling when I’ll get my car back.

Yesterday, Renee and I saw our family doc and I finally agreed to go on an antidepressant.  I’m on a ton of medications and hate the idea of taking yet another pill but it’s time.  The hardest part of transitioning from doctor to patient is the realization that “do as I say, not as I do” is a fool’s errand.  I spent 35 years tending to others, dolling out wisdom and secretly believing that because I was a doctor, I could ignore the rules.  What a fool I was.

If you’re depressed, get help! No one likes to admit to having depression. Depression is a normal human response to a multitude of things and we really need to get out of the Dark Ages and remove its stigma. If your doctor wants you on an antidepressant, take it.  If your doctor wants you to see a counselor, see one; and, if you are a doctor, realize you have to play by the same rule book your patients have. (Unfortunately, some state medical boards will suspend a doctor’s license if he/she has a diagnosis of depression).

By the way, I’m on a new type of “See Food Diet,” and its successful.  When I “See Food,” I run away.  I’m down 10 pounds.  I’m still as big as Jabba the Hut, who I’ll be for Halloween.

Here’s your joke for the day:

The IRS suspected a fishing boat owner wasn’t paying proper wages to his deckhand and sent an agent to investigate him.

IRS AUDITOR: “I need a list of your employees and how much you pay them”.

Boat Owner: “Well, there’s Clarence, my Deckhand. He’s been with me for 3 years. I pay him $1,000 a week plus free room and board. Then there’s the mentally challenged guy. He works about 18 hours every day and does about 90% of the work around here. He makes about $10 per week, pays his own room and board, and I buy him a bottle of Bacardi Rum and a dozen Budweisers every Saturday night so he can cope with life. He also gets to sleep with my wife occasionally.”

IRS AUDITOR: “That’s the guy I want to talk to – “The Mentally Challenged One”.

Boat Owner: “That would be me. What would you like to know”?

Shame on all of you!  The all of you I’m referring to are the Republicans and the Democrats.  You have turned a medical illness, Covid, into a political disease and, in doing so, have aided and abetted the pandemic and indirectly killed many Americans.  By inserting your political party’s interest into the battle against Covid, you have created confusion and distrust and have robbed your constituents of their peace of mind.

Over the last 40 years, I’ve had multiple new vaccines designed to defeat multiple infectious agents and not once have I had to deal with the confusion, fear and distrust sewn by the infighting between the Democrats and Republicans.  Over the last 40 years, I’ve given “one and done” immunizations that, in time, proved to give temporary immunity and require boosters.  Thank God, Washington stayed out of the immunization business until after I retired.

Let’s get one thing straight.  Our screwed up medical system does not reward doctors for preventative care.  That’s right. We get paid for treating illness and the worse the illness, the more we get paid.  So, when your doc recommends a vaccine to prevent a disease, he is cutting his own financial throat.

It used to take me 15 minutes to get a flu shot consent.  When my patient was particularly stubborn, I would thank them for not getting the shot saying, “I make $5 dollars off the shot and $350 if you get influenza.  My landlord, staff and wife thank you for taking the more expensive path and bolstering everybody’s bank accounts.

Do yourself a favor.  Ignore the Republicans and Democrats.  Ignore the president, google, your friends and family.  Don’t fool yourself.  It takes years of training to be good at understanding medical research.  Don’t do your own. CALL YOUR DOCS AND ASK THEM WHAT THEY RECOMMEMND.  Hopefully, they know you; and, for sure, they know what’s going on in your neighborhood.  Follow their recommendations.  While not being paid to keep you healthy, most docs are dedicated to improving your health by practicing preventative medicine.

One more thing.  As dangerous as Covid is, it is not close to being as bad as the political divide which is worsening day by day.  God bless you and keep you safe and healthy.  Remember, laughter is good medicine and it’s free. 

Here’re your jokes for today:

Q: What is the difference between capitalism and socialism?

A: In a capitalist society, man exploits man; and, in a socialist one, it’s the other way around. 

A little boy goes to his dad and asks, “What is politics?” The dad says, “Well, son, let me try to explain it this way: I’m the breadwinner of the family, so let’s call me capitalism. Your mother, she’s the administrator of the money, so we’ll call her the government. We’re here to take care of your needs, so we’ll call you the people. The nanny, we’ll consider her the working class. And your baby brother, we’ll call him the future. Now, think about that and see if that makes sense.” The little boy goes off to bed thinking about what dad had said. Later that night, he hears his baby brother crying, so he gets up to check on him. He finds that the baby has soiled his diaper. The little boy goes to his parents’ room and finds his mother sound asleep. Not wanting to wake her, he goes to the nanny’s room. Finding the door locked, he peeks in the keyhole and sees his father in bed with the nanny. He gives up and goes back to bed. The next morning, the little boy says to his father, “Dad, I think I understand the concept of politics now.” The father says, “Good, son, tell me in your own words what you think politics is all about.” The little boy replies, “Well, while capitalism is screwing the working class, the government is sound asleep, the people are being ignored and the future is in deep shit.”

I want you to meet the “K” brothers. My first attempt at finding a Podiatrist was a bust. My appointment was in the early a.m.  My afternoon patients always complained about how nasty my front desk personnel were.  While I didn’t condone it, I understood why they might be short with afternoon patients.  By noon, enough patients had complained about paperwork, waiting to see me, having to pay their bill, their insurance carrier and a hundred other things that my staff, clocked in at 7:30 and were pleasant caring individuals had morphed into professional hit men and women.

Anyway, the first doc’s staff were cold, uncaring, and definitely not helpful.  As it turned out, they were mirror images of their boss, the podiatrist.  He entered the room without knocking, quickly introduced himself and asked why I was in his office.  Before I could complete two sentences, he interrupted me, taking control of the conversation.  He assumed I wanted my nails cut, proceeded to cut them, then stood up and headed for the door.  I was having pain in my left great toe and I had to raise my voice to get his attention.  A quick exam, a short explanation and he was gone.  His nurse put my shoe on, took me to the desk, made an appointment for a 3 month follow up and out the door I went. I never went back.

Luckily, I found the “K” brothers.  I will refer to the brothers frequently in this book. Even though I was a last minute, appointment on a Friday afternoon, I was treated as if I was an old friend.  There was a knock on the exam room door and in walked a smiling, welcoming doc.  Dr. “K” asked me why I was there, listened to my complaint (I broke my toe when I fell), DID NOT INTERUPT, and then reviewed my physical exam and x-ray.  He reviewed my options, TOLD ME WHAT HE WOULD DO IF IT WAS HIS TOE, gave me a flat bottom shoe, made sure I understood the treatment options, then sent me home.

I instantly liked and trusted him.  His smile was genuine and infectious.  He was lighthearted, professional, and closed with a joke.  You would think he had been reading my blog.  I had met his brother once before.  I wondered if they were twins.  In one visit, the brothers had clearly developed a rapport with me and my wife that usually takes multiple visits to develop.

These docs are naturals.  My son, Jeremy, is a natural.  He can walk into any room and immediately make friends, establishing “rapport” easily.  He never studied “rapport”; it just came naturally.  If, while reading this book, you can learn how to instantly establish rapport, I will have accomplished my goal.  So, let’s look at some other docs and see if we can figure out how to establish and nourish rapport and what traits prevent the creation of a relationship based on rapport.

Here’s today’s joke:

I was at a football game. Sold out stadium, but the guy next to me had an empty seat next to himself…

…As the game wore on, I asked him “Who’s seat is that?” He looked at me sadly and said “That was my wife’s seat but she passed away.”

“I’m sorry to hear that.” I replied. “You don’t have any other family that might want to come to the game with you?” He shook his head and said “Nah… they’re all at the funeral”

When I transitioned from a practicing physician and began my new job as a full-time patient, I was lost.  Being on the patient side of the medical complex proved to be a daunting task, one I was not prepared for despite my 40 plus years of working as a physician.  As my journey took me from one doctor’s office to another, I quickly realized that my education as a physician was sorely lacking in one very important area. “A Doctor’s  Journey Into Illness, Lessons Learned” will address those areas where my education was deficient and propose changes to medical curriculums aimed at improving patient care by providing future physicians with the tools necessary to truly understand and treat the effects of disease as experienced by the patient with said illness.

When I retired and moved to North Carolina, I was forced to leave the comfort of a medical complex I was intimately familiar with and start anew with physicians who were totally unknown to me.  It was as if I was ill for the first time and had to learn my way around the medical world from scratch.  In writing this book, I did extensive research establishing relationships with a Gerontologist, Gastroenterologist, Orthopedic Surgeon, Neurosurgeon, Movement Disorder Specialist (neurologist specializing in Parkinson’s), Physiatrist, Otolaryngologist, Pulmonary Specialist, Dermatologist and Podiatrist.  I also had to learn the ins and outs of two hospital systems, Atrium and Novant.

If it sounds ridiculous to you, it is because it is ridiculous.  Yes, my health has deteriorated with problems in multiple organ systems.  Along the way, I have met physicians that I would rank among the best I have known and physicians who were not nearly as good as I require to be part of my health care team.  As you read the pages of this book, I will introduce you to various traits that this group of physicians have that make them either the best of the best or put them in the not-so-great category.

Defining the traits that make a physician good or not-so-good is not my intent, nor will it help future physicians to be better at caring for patients.  Afterall, who is good and who is not-so-good are highly subjective.  My hope and fervent desire is to propose a change to medical school curriculums that will address the differences in these physicians’ practices and enhance patient diagnosis and care in such a way that its benefits are sufficient to have medical schools adopt it.

Let me give you a general overview of my proposal. Fourth year medical students would become patients and be given scripts that lay out their medical histories, signs, and symptoms.  As much as possible, they are to act as if they have the disease. First year residents would then see them or actors, as if they were actual patients. Their exam and care would not be scripted.  All interactions would be filmed and then the films would be viewed and critiqued by the class and the professor.  The goal is to understand what a patient experiences when ill and seeing a physician and how the things physicians do, from the minute they walk into the exam room influences until they leave the room, effect the patient/physician relationship.

As my writing progresses, I will be publishing excerpts from the book on this blog and look forward to your input and any stories you have that might help patients, students and doctors navigate our healthcare system.

Here’s today’s joke:

I was walking down the street when I was accosted by a particularly dirty and shabby-looking homeless man who asked me for a couple of dollars for dinner.

I took out my wallet, extracted ten dollars and asked,”If I give you this money, will you buy some beer with it instead of dinner?”

“No, I had to stop drinking years ago,” the homeless man replied.

“Will you use it to go fishing instead of buying food?” I asked.

“No, I don’t waste time fishing,” the homeless man said..”I need to spend all my time trying to stay alive.”

“Will you spend this on hunting equipment?” I asked.

“Are you NUTS!” replied the homeless man. “I haven’t gone hunting in 20 years!”

“Well,” I said, “I’m not going to give you money. Instead, I’m going to take you home for a shower and a terrific dinner cooked by my wife.”

The homeless man was astounded. “Won’t your wife be furious with you for doing that?

I replied, “Don’t worry about that. It’s important for her to see what a man looks like after he has given up drinking, fishing and hunting.”

Five days ago, I embarked on the most fantastic vacation I had ever been on.  Unfortunately, my vacation ended today.  I went to a land I’ll call “Me.”  I haven’t been to “Me” in years.  As a matter of fact, I had forgotten what it was like to be “Me”.

I need to give you some background information first.  As time passed, Parkinson’s proved to be a skilled butcher, carving away small pieces of my physical being and large chunks of my soul.  The changes have been dramatic when viewed in aggregate.  Yesterday, I came across a picture of me from 2017.  When I compared that picture to a current picture, I realized how thorough Parkinson’s had been at destroying the man I was meant to be, leaving behind the creature I had become. 

The creature I had become was a jealous one.  It would sit outside on its walker and watch its neighbors go on their morning walks.  Its abilities had been so diminished that walking any distance had become next to impossible.  My neighbors walked on a solid surface, enjoying the beautiful North Carolina days while I walked in quicksand and pain.  I thought, if only I could walk, I’d be happy. 

I’ve searched the medical world for an answer, to no avail.  The search did reveal that, in addition to Parkinson’s, I have cervical disc disease with a disc herniation at C4-5, along with a long list of other disorders.  I wasn’t joking when I described Parkinson’s as a butcher, but I failed to mention that its assistant in my destruction was Father Time.

Now, back to my trip.  My neurosugeon sent me to a physiatrist to try to deal with my pain.  Dr. Plummer is a ray of sunshine in an otherwise dark world.  We talked about options; and, as a short-term fix, she started me on a steroid dose pack. I went to sleep in my hideous body and awoke in the land of “Me.”

Yep, the next morning I could walk better, move better; and, for the most part, I was pain free.  I felt like “me” for the first time in years.  My companion, Parkinson’s, was still there; but the real “me” had taken over.  It was heavenly.  I was back on dry land and functioning.  My sense of humor returned.  I was fit and ready for duty.  It was as if my prayers had been answered.    

Unfortunately, you can’t stay on steroids forever.  Dr. Plummer had given me a 6-day pass and that pass is expiring today.  A Medrol Dosepak starts off with 6 pills on day one and the dose decreases by 1 pill a day.  My trip is coming to an end.  Six pills were marvelous; 2 don’t cut it.  Unfortunately, the butcher’s work is permanent; and I’m returning from the land of “Me.”

I am grateful for the short vacation.  I am better than I was before I took this trip, as I know, buried under a pile of Parkinsonian shit, “me” still exists.  I will continue to look for a way back to the land of “Me” but, mired in quicksand, doubt I’ll find it.   

Today, most doctors follow rules and there are rules that govern the use of steroids.  In my day, doctors made up their own rules, understanding that there were risks and weighing the risks vs. the benefits.  Perhaps I will find a doctor willing to break the rules and give me a trip to the land of “Me” on a more regular basis.  We’ll see!

Here’s today’s joke:

A biker walks into a bar and sits down on a bar stool near the end of the bar.

He takes a look at the menu and it reads as follows:

Hamburger – 2.99

Cheeseburger – 3.99

Chicken Sandwich – 4.99

Hand Jobs – 19.99

The crusty old biker waves the bartender down and up walks this tall, busty, beautiful redhead in her mid-twenties. She smiles at the biker coyly, and he asks in a quiet voice, “Are you the one who gives the hand jobs?” The bartender blushes slightly and says, “Yes, I am” with a sexy little smile. The biker grins and says, “Well, wash your hands, because I want a cheeseburger.”