Archive for Ease and Disease

Probably no warranty, either

I feel like hell these days, what with that plumbing scare a couple of weeks ago and the refusal of Old Man Winter to bugger off already. I don’t think, however, that this is quite the cure I’m looking for:

A surgeon says full-body transplants could become a reality in just two years.

Sergio Canavero, a doctor in Turin, Italy, has drawn up plans to graft a living person’s head on to a donor body and claims the procedures needed to carry out the operation are not far off.

Canavero hopes to assemble a team to explore the radical surgery in a project he is due to launch at a meeting for neurological surgeons in Maryland this June.

Given transplant statistics generally, you have to figure that you’re not going to have much choice in donor bodies.

According to the procedure Canavero outlined this month, doctors would first cool the patient’s head and the donor’s body so their cells do not die during the operation. The neck is then cut through, the blood vessels linked up with thin tubes, and the spinal cord cut with an exceptionally sharp knife to minimise nerve damage. The recipient’s head is then moved on to the donor’s body.

The next stage is trickier. Canavero believes that the spinal cord nerves that would allow the recipient’s brain to talk to the donor’s body can be fused together using a substance called polyethylene glycol. To stop the patient moving, they must be kept in a coma for weeks. When they come round, Canavero believes they would be able to speak and feel their face, though he predicts they would need a year of physiotherapy before they could move the body.

You’re not getting me near polyethylene glycol. I had to drink about a gallon of it before colonoscopy.

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Couple of the year

From the Why Are They Together? files, this item from up the turnpike:

An Oklahoma man says he nearly lost his penis when he woke to find his girlfriend trying to bite it off.

A night of drinking and arguing led to the painful arousal when the victim said he found Amber Ellis “biting his (penis) off” as he slept on the couch Thursday, KJRH reported.

One may surmise that he was at a disadvantage during their, um, disagreement:

He told Tulsa police he fought the 31-year-old off but in the process she hit him in the head with a laptop computer.

Their earlier argument was over his accusing her of being too needy, he said.

Well, at least it wasn’t over whether she swallows or not.

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Over easier

For at least half my life, the powers that be, or that imagine they be, have been warning me about cholesterol, coursing through my body like liquid plutonium or something. I am somewhat pleased, yet still somewhat annoyed, that they’ve now admitted that they were just kidding:

The Dietary Guidelines Advisory Committee has taken cholesterol off the list of things that are automatically bad for you if you are an otherwise healthy person. Cholesterol, like just about anything already in our bodies or in our food, can cause you problems if you have too much of it already or if you consume too much of it, but isn’t necessarily the One Ring of Dietary Substances.

This was probably inevitable once they figured out that “good” cholesterol wasn’t all that good and “bad” cholesterol wasn’t all particularly bad, and neither of them, from my point of view anyway, were as bad as statins, which overlaid my entire structure with random weakness. (On the upside, statins gave me a great excuse to not drink grapefruit juice, as though I needed one.)

Still, the exasperating aspect of this is that there continues to be a Dietary Guidelines Advisory Committee at all. And given current trends in corruption, I suspect there will someday be a Recommended Daily Allowance of Pepsi, or something equally implausible, because dollars were spent to support it.

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Outward buckpass

Why, yes, your personal information was jeopardized. Want to know what we’re going to do about it? Take a guess:

[B]ecause I have BC/BS health insurance … well, I wasted a good part of Friday morning on the phone with the credit bureaus getting holds/fraud alerts placed on my accounts, because apparently our information was among that in the Anthem breach. Now someone is telling me I need to contact the IRS and tell them not to process any address changes put through in my name in the next x period of time … and I just can’t. I can’t call that awful phone-tree and try to figure out whom I need to talk to and get kicked out three separate times and have to go through it again like I did the last time I had a problem. I’d hope that Anthem would do something towards taking care of that for us, or if they won’t, I guess I just file as early as I can and hope no one is going to try to use my SSN for nefarious purposes.

It would be most unkind to point out that, no thanks to a far bigger scam than mere identity theft, the IRS and the health-insurance industry are now joined at the hip. This is like Cthulhu hiring an adjunct.

We’ve also been warned to watch out for e-mail scams offering us credit monitoring, supposedly in the name of Anthem. It’s like, “You ALREADY have my personal information, this just adds insult to injury.”

A two-for-one deal! Expect Leviathan to promote the hell out of it on social media.

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A high bill, but it’s clean

Last week, you may recall, I reported in to the family physician with a bladder complaint: it always seemed full no matter how long I spent in front of the porcelain facility. Said the doctor, it’s probably an infection of the prostate and/or just that it’s grown a bit, as it does in old geezers like you and me. (He’s about my age.) He prescribed a pair of drugs: an alpha blocker to reduce the pressure and maybe shrink the tissue a bit, and five days’ worth of almost industrial-strength antibiotic to clear up any lingering infection. “However,” he said, “I’m just old-school enough to order a PSA test.”

Said test was graded Friday, and the score reported back to me today. Evidently I passed, by which is meant that no further testing is anticipated. The Reaper, that scythe-wielding son of a bitch, is thwarted once more — for now.

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I, pincushion

From earlier this week:

Also in decline: my ability to avoid restrooms. This has not yet been diagnosed, but the only likely causes seem to be some sort of urinary tract infection, or a prostate grown to the size of a Hyundai. (I am steering clear of advisory sites such as WebMD, inasmuch as almost every conclusion they reach seems to suggest imminent mortality.) Admittedly, I do gulp down a lot of liquids, but kidney function, which is checked regularly, has been up to snuff. For the moment, though, it’s bad enough that I expect it to cause an increase in night terrors, assuming I can sleep at all with this condition.

The diagnostic process has begun, despite an inability to coax this old body to give up any fluids. (It took two sticks to obtain blood; the bladder that felt full couldn’t fill a third of the cup.) Kidney function has been cleared; says the doctor, these conditions are consistent with a prostate ailment, though his personal inspection didn’t yield much more than an Accent. I was, of course, expecting a Sonata, or maybe an Azera.

So, in addition to my beta blocker, I now get an alpha blocker. At this rate, eventually there won’t be anything left to block. And in case there is an infection of some sort after all, there is an antibiotic. The last three antibiotics I’ve been prescribed have been different, which I attribute to whining about amoxicillin, which gives me something resembling diaper rash, except on the face. I am comforted, mildly, by the fact that while I’m being prescribed more damn drugs, they’re cheap damn drugs.

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Declining utility

I’ve never been this old before, and I definitely feel like it.

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I think this might hurt

Maybe it would work with half a 100-mg tab. Then again, this is an antihypertensive, and I’m not at all sure how it would affect one’s eyes.

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My share of the debacle

In December, CFI Care [not its real initials] made a presentation at the office, presumably to sell everyone on the benefits of the new government-approved health-insurance policy being sold us. I missed it, as I was already ill, though it was whispered to me that the old $3000 deductible was being replaced with a new $5000 deductible. I suggested that this was scarcely an improvement, and got a half-hearted shrug in return, a shrug that said “Yes, yes, we know, but what can we do about it now?”

Back in the days before bronze and silver and gold, when they were talking about Cadillac policies, what we had was basically a five-year-old Pontiac with a leaky valve-cover gasket. The office picks up my premium expense. However, I estimate my additional out-of-pocket expense, based solely on the new copay specifications, at $800. God forbid something should actually happen to me in this ’96 Hyundai with bad brakes.

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An insistent voice in the dark

This has been passed around 125,000 Tumblrs so far:

brain: i see you're trying to sleep, can i offer a selection of your worst memories from the last 10 years

There are times that I think this must happen to everyone, with the only difference being the number of years.

(Via Rebecca Black.)

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Allergen detection kit (home version)

If you ask me, this can’t happen soon enough:

“It would be really nice if a person with food allergies could get test strips that they could dip into a food they were concerned about, and it would turn color if the allergen was present.”

I was thinking about the glucose test strips we use in one of the labs I do — they are a product sold for diabetics, so they can test their urine. There are also color-changing tests for lead in paint, and I am sure other things I am not thinking of.

But what nice peace of mind that would be — “I don’t know for sure if this broth might have miso in it, so let me check.” or “Could there be peanut proteins in this smoothie?” (I can see how it would only work for liquid things.)

I doubt you could get every possible allergen detected by a single strip. (Then again, I am not a biochemist, nor do I play one on television.) But even if you have to special-order strips for your one-in-a-million sensitivity, it’s still better than hives.

Disclosure: I don’t have any food allergies, or at least I’m not aware of any. I still think it’s a swell idea.

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Just say no to drugs

Wait a minute. Not these drugs:

Is this some quirk in New York law, or does someone simply not know how to set prices?

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Bacteria put on notice

The major problem with antibiotics, as you know, is that the biotics are actually alive, and therefore evolve; bacterial strains with the greatest resistance to the drugs survive, and eventually resistance becomes the rule rather than the exception. (Viruses just laugh at antibiotics.) The result: a continuing need for new antibiotics. Unfortunately, creating new antibiotics in the laboratory isn’t especially simple or particularly inexpensive.

So when you find one out in the yard, it’s a big deal:

Scientists have discovered an antibiotic capable of fighting infections that kill hundreds of thousands of people each year, a breakthrough that could lead to the field’s first major new drug in more than a quarter-century.

The experimental drug, which was isolated from a sample of New England dirt, is called teixobactin. It hasn’t yet been tested in people, though it cured all mice infected with antibiotic-resistant staphylococci bacteria that usually kills 90 percent of the animals, according to a study published [Tuesday] in the journal Nature. Bacteria appear to have a particularly difficult time developing resistance to the drug, potentially overcoming a major problem with existing antibiotics.

Magic bullet? Not really. It’s not by any means a universal treatment:

The drug worked best against what are known as gram-positive bacteria, which have weaker cell walls and includes streptococcus and MRSA. Gram-negative bacteria have stronger walls and include pathogens such as E. coli.

Teixobactin was also able to successfully attack drug-resistant strains of tuberculosis, which is neither clearly gram-positive nor gram-negative. The researchers are working on adaptations to make teixobactin effective against gram-negative cells as well.

There are hurdles yet to come. Said the nearest microbiologist with whom I’m on speaking terms:

I’m not really impressed by the latest news that a new antibiotic has been discovered. Tell me again once it passes human clinical trials… In that paper, they tested their new antibiotic against lab strains rather than bacterial strains isolated from patients.

And if it’s ever going to be approved for human use, those clinical trials are a must.

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When the brain hurts

Depressed? “Buck up,” they say. “Smile a little.”

They are, of course, full of crap.

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Beyond comprehensive

One of the arguments in favor of the individual mandate in the Affordable Care Act — which, to the surprise of no one actually paying attention, required a mere 67-percent increase in my annual deductible to qualify the corporate policy without sending the premium to the stratosphere — was that “it’s just like car insurance, nobody has a problem with that being mandatory.”

Well, no, I don’t have a problem with that. I’d point out that rather a large percentage of drivers have been ignoring that particular mandate all along, but ultimately I suppose I need to be more concerned about people who simply can’t read policies:

Yahoo Answers screenshot: My motor is messed up in my car will my car insurance pay for it to get fix?

Short answer: no. And there’s really no need for a long answer.

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Alone in the cold

The 24-hour bug persisted for a lot longer than 24 hours, and all of a sudden things look a great deal bleaker than they did a couple of days ago.

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Snot what one aspires to

Tam has been suffering with some wretched disease this week, and I think it was worse than what I have, based on this observation:

About the middle of the afternoon yesterday, I became one of the world’s leading exporters of mucus. It’s tapered off greatly this morning and is no longer coming out in festive colors, so everything should be good and copacetic by nightfall, but that was really unpleasant.

You probably don’t want to spend any time wondering who might import the stuff.

It occurred to me that we really need some new drugs to replace the wimpy stuff they sell over the counter at Rite-Aid: the bloody dismembering of NyQuil is still fresh in my mind.

Or maybe we need some old drugs:

One Night Cough Syrup

I defy anyone to cough after a tablespoon of that.

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Sick as the nearest canine

About 8:30 this morning, it hit.

“It” may be a rhinovirus, or it may be something much worse. I’m not planning on something worse, mind you; but anything that keeps me awake at night is horrible by definition, and the longer it takes for me to drift off, the more likely I’ll pray for eternal surcease.

In one of God’s little jokes, I have an actual medical appointment scheduled for tomorrow. (I figured that CFI Care — not its real initials — would be jacking up the rates at the end of this month, and indeed they are: copays will rise up to 17 percent, and the annual deductible is now $5,000. I didn’t get the usual handout, but I suspect the base rate for this gold silver bronze pyrite policy is now up over $6,000 a year. It could be worse; and I expect it will be next year. And no, I qualify for no subsidies.)

Then again, if it actually kills me — well, something had to at some point.

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I remember this scheme

I spotted this on the back of Parade yesterday:

If your loved one is currently taking twice-a-day Namenda tablets, ask the doctor about transitioning to once-a-day Namenda XR.

Namenda (memantine) is recommended for, as Wikipedia says, “managing Alzheimer’s disease,” and by “managing” is meant slowing the clinical deterioration associated with the disease, since there is no actual cure.

Still, a once-a-day capsule would seem to have only marginal benefits over a twice-a-day tablet, but … Never mind. I might have known:

Forest Laboratories wants more people to use its once-daily version of Namenda. It is, after all, the formula launched just last year, the one that theoretically stays on patent till at least 2025. So, it’s planning a “forced switch.” Forest will discontinue its original Namenda pill in August, pushing current patients onto Namenda XR — and hoping they won’t bother to switch back when generics appear next April.

A third option, an oral solution, remains available for the moment.

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Put-ti-put-ti

Meanwhile in Denmark, this would seem to be concrete evidence for some sort of malfeasance:

National authorities have shut down a company that produced food for nursing homes and hospitals in a cement mixer.

The Danish Food and Veterinary Administration (Fødevarestyrelsen) discovered that the food company Nordic Ingredients violated hygiene rules by producing gelled foods in a cement mixer. The food was delivered to public nursing homes and to hospital patients who have difficulty swallowing whole food.

Thereby confirming your worst fears about hospital food, no doubt. And furthermore:

A Food and Veterinary Administration official said that in addition to producing food in a cement mixer, the hygiene levels at the company’s production facility were abysmal.

“It wasn’t just a bit of mess from the most recent production, and we determined that the cleaning standards were completely inadequate,” Henriette Mynster told DR.

I suspect government procurement rules, and all that lowest-bidder jazz. It will happen here soon enough.

(Via Bayou Renaissance Man. If you don’t get the title, get this.)

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From the “It could be worse” files

Vinny, via Tatyana, speculates on the impact of Ebola on the country in general and on New York City in particular:

Ebola outbreak creates havoc in our major cities, doctors and nurses flee for safety, and local population ends up tending for itself. This is what is now happening in Sierra Leone, Guinea, and Liberia. Economic impact will be more substantial than the number of people actually sick with Ebola, and it will be a nightmare living in a major metropolitan area. Food supplies will run short and you can forget about going to the emergency room in case you break something, develop an asthma attack, or even have chest pains. If what you have is less likely to kill you than visiting an emergency room teeming with Ebola victims, then you best stay home. I think about 1000 victims in NYC will create such a scene. If you consider that the virus doubles its victims every 3 weeks and that we are now bringing about one new carrier each week to the U.S. (about ½ will go to NY JFK and Newark airports), we are anywhere from 30 to 12 weeks from such a hellish possibility if the virus continues to invade the human population at its current rate. Still this scenario remains limited to causing most of its damage in 2014 and 2015, with life returning to normal afterwards.

Ranking “best case” to “worst case” one to six, this is number three.

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This made me weepy

I can deal with cold, and I can deal with dark, but the combination of dark and cold wears on me after a while, and for “a while” read “two days at most.” It’s this damn brain chemistry, maybe:

Scientists say they have identified the underlying reason why some people are prone to the winter blues, or seasonal affective disorder (SAD).

People with Sad have an unhelpful way of controlling the “happy” brain signalling compound serotonin during winter months, brain scans reveal.

As the nights draw in, production of a transporter protein ramps up in Sad, lowering available serotonin.

Apparently this is proper British usage, to capitalize (sorry: “capitalise”) only the first letter of the abbreviation. But it certainly reinforces the idea of, um, Sadness.

Lead researcher, Dr Brenda Mc Mahon, said: “We believe that we have found the dial the brain turns when it has to adjust serotonin to the changing seasons.

“The serotonin transporter (SERT) carries serotonin back into the nerve cells where it is not active — so the higher the SERT activity, the lower the activity of serotonin. Sunlight keeps this setting naturally low, but when the nights grow longer during the autumn, the SERT levels increase, resulting in diminishing active serotonin levels.

“Many individuals are not really affected by Sad, and we have found that these people don’t have this increase in SERT activity, so their active serotonin levels remain high throughout the winter.”

Mc Mahon is part of the Neurobiology Research Unit at the University of Copenhagen.

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Doctor’s ordure

First, the setup:

Let’s make no mistake: the current Ebola epidemic is a terrible humanitarian disaster in Africa. We should be doing everything we can to help alleviate the suffering on the ground there. As a parent, it’s hard to bear images of children orphaned and parents bereaved. As a physician, I would hop on a jet and lend my hand — if I wasn’t such an insufferable, pampered wuss.

Feel free to sing along with the punchline.

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The thirteenth is due

Because look what happened to the twelfth:

Doctor Who with ebola?

To quote Doug Mataconis: “Doctor Who has Ebola? Now we’re really screwed.”

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Hurting less

Fillyjonk, in a pensive mood:

I vaguely remember from Great Books (that was 25-odd years ago now) that some Greek philosopher or other described pleasure as being the absence of pain, and one of the thoughts I had in the class (can’t remember if I brought it up now) is that so often in the modern world, we now define “pain” as the “absence of pleasure” — that is, if you’re not actively enjoying yourself, you consider it painful. (“Math is hard,” said Barbie.) And a lot of people do seem to have forgotten that there’s a joy in good old hard work and that even stuff that isn’t fun at the time can teach you something.

That was Epicurus, who in contemporary times seems to have acquired a reputation for being something of a swinger, or at least advocating being something of a swinger. In fact, he did nothing of the kind; what Epicurus advocated was striving to rid ourselves of pain and suffering, which would perforce leave us in the pleasurable state of ataraxia, defined spiffily as “robust tranquility.” I could definitely go for some of that.

But, last night, as I got into bed, I thought, yeah, when you’ve been in pain for a while and that pain goes away, it IS pleasure. And it’s something to be grateful for, and I was.

As Johnny Mercer teaches us, we need to accentuate the positive. (Mercer, for his part, says he got it from Father Divine.)

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Perhaps they’re drugged

The old online prescription refill at Target was clunky in the extreme, but it worked most of the time. And then they decided to outsource it, to an operation called PDX, Inc. It’s still clunky, but now it doesn’t work at all: since it didn’t read any existing cookies, it defaulted to filling my order at a store in Pennsylvania — except that it refused to fill my order because it didn’t like any of the prescription numbers I keyed in. Twice.

What’s more, it has a CAPTCHA.

Whatever the opposite of “I wish them well” may be, that’s what I wish.

Addendum: I whined on Twitter about this, prompting Target HQ to ask me for an email report.

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Sentimental on my mind

Glen Campbell, now in the final stage of Alzheimer’s, will soon leave the stage entirely. He has left us one last song, with the ironic title “I’m Not Gonna Miss You”:

The melody is somber and contemplative, but the lyrics show Campbell’s ability to find irony in his disease. The result is a beautiful combination of sadness and joy, which ends much too quickly.

At least the man from Delight goes out on a somewhat-happy note.

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On the edge of the Everdead Forest

All eyes are turned to Dallas, no thanks to some schmuck who’s been incubating Ebola, and Nightmare Nights, a My Little Pony convention coming up in the area, answers the question “Would it kill you to attend?”:

The patient was been placed in isolation — separate medical staff, separate water supply, and in-room destruction of all materials — at a hospital just over 30 miles from our convention venue, and remains there today. “Dallas” is a metropolitan area encompassing 9,286 square miles. It’s bigger than Rhode Island and Connecticut combined. Trust us, we are well away from this hospital.

The venue is actually in the town of Addison, at the far north end of Dallas County.

Further reassurance:

We are not altering our plans for Nightmare Nights. Nor has school been cancelled, nor has public transit been altered, nor have any area concerts or sporting events been rescheduled. We know news organizations like to get your attention by talking about epidemics — remember when SARS, bird flu, or swine flu were going to bring the country to a standstill? — but everything here is pretty much normal.

And sneaked into the bottom:

TL;DR: There is no Ebola “outbreak.” However, as the patient reported symptoms on September 26th, we will note that Nightmare Nights is exactly 28 Days Later.

Well played, gang.

(Via EqD. Warning: Picture of Ebola Pony.)

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Random afflictions

I worked, if not extraordinarily hard, at least hard enough today to push this old body into putting up some resistance; just short of the nine-hour mark I felt like someone had decided to shove a meat thermometer into my shoulder. It didn’t last long — a couple of seconds — but it apparently triggered every conceivable source of pain I have, and a few I didn’t comprehend at all. I’d had this happen once before without side effects, so this event was decidedly more disturbing, and my heart rate picked up markedly, especially after walking around distributing stuff. For a moment I contemplated not actually driving home, lest several systems fail at once, something that’s not good at rest, and even less so at 65 mph.

Symptoms continued to be wildly variable until dinnertime. It wasn’t that I was hungry, exactly, but climbing up on the stool at the breakfast bar got me off my feet for not quite half an hour. Still, I’m a bit woozy, and I still have shoulder pain, though it’s in the other shoulder. I did try one of my more recent mantras: “Outlive Zeke Emanuel.” It helped a little, but not enough.

I expect I’ll be back at work before sunrise: these things never last long — except, of course, for the last one.

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Catheters to the sky

Few organizations can build, build, build like big hospitals, especially big “non-profit” hospitals. Jack Baruth has damned near financed one himself:

The hospital in Upper Arlington that handled my trauma case in 1988 handled my trauma case in 2014. It’s quintupled in size, the original tower where I entertained my visitors now an embarrassing old relic surrounded by monstrous, architecturally-complex structures with the sheen and swagger of Las Vegas casino hotels. The population it serves has remained more or less static since ’88, so why have the buildings multiplied? The same thing hasn’t happened to my local fast-food restaurants or auto-parts stores.

Part of it’s the aging and sickening of the Boomers, but most of it is simply the fact that healthcare costs and profits are soaring in this country at a rate typically reserved for college tuition, and for the same reason: there’s a disconnect between the people who receive the service and the people who pay for it. Healthcare is the new oil boom or gold rush, but the resource we’re mining is a resource called ourselves. There’s no limit to the amount of money you can make.

Unless, of course, you’re a doctor. Doctors and nurses aren’t clocking all this crazy cash. It’s going to massive billion-dollar corporations that provide medical supplies, devices, tests, and all the junk that surrounds you when you enter a hospital. Cotton swabs made in a Mexican factory for fractions of a cent and sold to you like they were solid gold. Drugs that cost pennies to produce and thousands of dollars to buy. Patented tests and procedures that you’ll demand because they offer you a one-percent chance of living longer at the cost of your entire retirement savings. Because what’s the balance sheet of your employer or your insurance provider or even your own family against the prospect of life or death?

Just don’t tell Zeke Emanuel how old you are.

(Semi-amusingly, someone edited Emanuel’s Wikipedia page yesterday to show him as having died yesterday. I’m pretty sure he’s not dead.)

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