Of the four facilities I currently work at the high security penitentiary is my favorite, and where I spend most of my week. I find the higher security Uber maximum prison to be draining. The inmates are constantly locked down, they have nothing to do most of the day but fester on their problems which often makes their quasi-medical issues become immediately life threatening in their own minds. The inmates at the low security and medium security facilities sometimes don’t realize they are in prison. I often get of mirage of complaints about the wait time for medical, or why they can’t have their turmeric ginger tea shipped in. At the pen the inmates know they are in prison, most are convicts that have been in for the greater part of their life and still have several years to go. The Penn is what you imagine prison to be like. Gangs, fights, drugs, it’s all there. What follows is an average day in my life. Read more
In life there are often a few defining moments that result in our courses being forever altered. We tend to follow a very structured path, even if we think our lives are chaotic when compared to those around us. We still have a plan and a path in front of us about where we at least think is pointing us in a good direction that we can make sense of. Then there are moments that are sometimes tragic and sometimes magic that flip us right off our path and into the abyss of uncertainty. We feel unraveled in these moments, these are moments when one path is gone and no others are apparent. We feel lost, scared, and just generally anxious and confused . It’s only when we grab back on to a new path and climb aboard that we start to feel more stable, when all the intangible components of our personality and our desires find hope in a new direction, even if it’s just a sliver of such. I feel like it’s like a black box. Like we are all just chugging along and then we hit a black box, we go inside, a bunch of stuff happens, and we come out on the other side in a new direction. Sort of like the kidney, we don’t really get it, but our blood somehow turns to piss, and all is well. Read more
It’s been almost a year since my last blog. Much has happened and in some ways its been a little overwhelming to absorb all the transitions that have unfolded. Although, I suppose that in itself is not special. We all live our own important lives with transitions and adventures in our own way. So in some sense that is no excuse for not finding the time and mental space to keep writing. This blog helps me make sense of the world, the brilliance, and idiocy that surrounds me. Ultimately writing helps me to figure out which one is which. Perhaps I’m shy to write more again as I’m pretty sure I’ll just wind up finding idiocy in my own self perceived brilliance.
In summary over the last twelve months: Read more
As a physician I have learned that we lose so much in the hustle of the modern day clinic. In order to deliver optimal wellness we must be aware and empathetic to the immutable values, vulnerabilities, and often overseen intricacies that make up the persona of our patients.
We walk many lines in life. Sometimes these lines are well structured with clear and concise paths laid out in simple steps. Sometimes they are serendipitous. Most of the time we don’t see the lines for what they are. They are simply lines. Lines that we’ve created by our free will and choice. These lines cut and shape the seemingly gelatinous space that we call our lives to give us an idea of purpose, direction, and ultimately the identity of what we see ourselves to be. Sometimes in rare glimpses we are allowed the fluke chance of circling back and re-emerging on a line after a tangential circumnavigation through the life jelly, and in these strange moments we see can see a little more clearly, and we see that defining ourselves solely by the line we walk in life is a bit of a joke. If there are an infinite amount of possibilities in how we cut through the jelly than one singular path cannot possibly be our definition. Our identity that is immutable is the substrate between the lines. How we shape that substrate with these lines and paths through higher education and the carnival of the modern business world is just a byproduct of living in the modern world, and not as meaningful to our real identity as we are trained to think. Read more
It’s common language now to say that we have one of the best health care systems in the world, but some of the worst access to care. In my mind this is true, but it’s missing the point. In thinking about healthcare as a business saying that we have poor access to care is basically saying we have a great product, but our potential customers due to various reasons can’t figure out how to use it. We take a passive approach when we start placing the burden of our failing system on access to care alone. Our model is complacent with the concept that the patient will come to us. We commonly accept the idea that our patient’s will negotiate their own insurance, co-pays, and the myriad of other complexities involved in acquiring and utilizing healthcare. In short, we have the potential to offer a brilliant product, but we over rely on our customer to do all of the work to reach what we are selling, and often through a web of tangled bureaucracy. Our access to care is indeed terrible, but poor delivery is equal to blame. What are we doing as a medical community to offer new innovative ways that would allow our patients not only quicker and more efficient care, but a delivery mechanism that takes the burden of procuring healthcare off patient and more on the infrastructure? Read more