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Thursday, January 31, 2013

A Son for My Gun – Part III



            I have spent the last two blogs going back and forth on the gun control issue.  The truth is that there are justifiable arguments on both sides of the issue.  Gun control is so complex that there will be success stories as well as failures no matter what decisions are made. 
            The only thing I am certain of is that something has to change.  We need to start somewhere.  Small steps are how a democracy works.  For some any change is tough to bear, while for others slow progress is too difficult to witness.  However, change is usually only tolerable when taken slowly.  Twenty years ago smoking was the norm, but look at where we are now; how far our society has come, and few will argue that we are not better off for it.
            So, as we search for a common ground that can satisfy both gun advocates and anti-gun activists, we need to simultaneously focus on the larger issue that is killing Americans both with guns and without.  We are all dying by passing on a disease and the escalation in gun violence is a deadly symptom of the illness.
            I have been working in the ER for almost 15 years, and have witnessed this disease first hand.  I can tell you that it is getting worse.  Patients continuously flood the emergency room with non life threatening conditions.  When a person comes to an ER with a cough for 3 weeks and becomes upset about having to wait while patients with real life threatening conditions are taken care of first, then complains to administration, which triggers an administrative backlash against those trying their best to save other human beings’ lives, is to a much lesser degree the same illness that makes someone go on a shooting spree.  Some may argue otherwise, but it is the same problem.  An annoying cough that does nothing more than cause someone to stay awake at night is a sign of the same process within the body as the truly ill individual with life threatening pneumonia having difficulty breathing and coughing up thick, copious amounts of phlegm.  One is a progression of the other.
            Our society is deteriorating and it is progressing at an astounding rate.  The fairy tale stories we tell our children with their underlying lessons of morality are truly becoming fairy tales.  On the surface we teach our children to be honest, trustworthy, compassionate, and tolerant to others.  We encourage them to share and work hard, yet the true values we are passing on to the next generation are deceit, selfishness, greed and laziness.  We are culture inflicted with a sense of entitlement at the expense of everybody else.  Work ethics have all been forgotten.  Excuses have become our mottos.  Patience and tolerance of others is lost, and responsibility is a four letter word.
            When I began practicing medicine 15 years ago I rarely saw psychiatric conditions listed on patients’ medical records.  Today they top the charts.  People of all ages, ethnic groups and demographics are being diagnosed with mental illness.  They are being prescribed drugs to treat these ‘illnesses’ and are being absolved of responsibility for their behaviors.  I also believe that these medications are inhibiting people’s natural ability to cope with stress and heal themselves of what truly ails them. 
            The simple truth is that life is hard.  Few of us are born into privilege, and even those that are have trouble dealing with reality.  We all want to be rock stars, movie stars, sports heroes and not just multimillionaires, but billionaires.  However few of us are willing to do the work and take the risk to achieve success.  When we fail we are no longer able to cope with the left over reality and resort to drugs (legal or illicit) and simply make excuses for our failures.  We blame others for our shortcomings in life and in various ways lash back; unfortunately for some it is in the form of mass murder.
            Pain is a part of life.  It is natural, but our intolerance to experience any form of pain, whether it is physical or psychological is making us unable to cope and function effectively within a society.  Disappointment helps us appreciate our successes.  Our children are not being given the chance to experience this.  At my son’s science fair, everyone got a ribbon.  At my daughter’s gymnastics competition, everyone got a metal.  What is a contest if everyone wins?  In life, some people win but the majority lose. That is reality. Losing should encourage us to work harder. Simple as that.  No excuses. 
In order to stop killing ourselves we need to take some real medicine.  There is no pill to take.  This antidote tastes bad and it is hard to swallow.  It is humble pie covered in a bitter coating of ordinary and obscurity. I believe we need to stop making excuses, stop being politically correct, and stop worrying about what everyone else is doing.  We need to wake up to reality, even though it is not the fairy tale of our dreams.  Just because it is not what we hoped for doesn’t mean we can’t find happiness within it.  When we finally start facing our demons and beat them back to hell, then we will have peace on earth and live amongst each other with out killing one another.  This is not only the solution to gun control but it is the answer to everything from our failing economy to the drug war.
We need to ‘Suck it up!’ America.  Amen! 

If you want to hear more bitching on this topic you can find it in my book ‘MediSin’.  You will also be entertained by stories of various freaks that have presented to the ER.      

Buy Niam Hew's new book MediSin NOW!

Tuesday, January 22, 2013

A Son for My Gun – Part II



           The gun control issue has many faces.  It is a complex problem.  The positions taken by liberals who support the destruction of every gun in America and abolishing  the production of any additional firearms is just as closed-minded and dangerous as the far right conservative perspective that every American has the right under the constitution to own any form of firearm and display them for the entire world to see.  Both extremes have potentially dangerous consequences that could end in violence and the deaths of many innocent people, including recurrences of Sandy Hook. 
            If you support the idea of a complete ban of guns then you are being naïve and not accepting some harsh truths about our society and the boogie men that walk our streets.  That is not paranoia but an unfortunate fact.  Just as laws in the past did not stop people from drinking alcohol during prohibition or women getting illegal and dangerous abortions (all of whom were technically criminals in the eyes of the law at the time), the abolition of guns will not stop criminals from finding the means of arming themselves, while law abiding citizens will be left defenseless.  Such a law may deter an event like Sandy Hook or Columbine, but I believe it will enable more violence and criminal activity than it will stop.  Just as a patrol car will get everyone on the street to obey the speed limit, or even the sight of a uniformed police officer will prevent a crime from being committed, the understanding that an average citizen may have the means of defending themselves will deter many criminals from engaging in criminal activity.  A woman walking down the street alone has a larger criminal target audience than the same woman walking along side a man.  There is even additional deterrence if the guy is a giant at 6’7”.  Criminals are not irrational.  They are calculating individuals and want their booty with as little effort and risk as possible.  If the crook believes that there is a good chance that they could become the victim they simply look for an easier target.
            In addition, this fear of the all powerful assault rifle, with its ominous black outline and alien looking design, is misguided.  Reality is that the majority of gun related violence, including mass shootings, are carried out with handguns.  In fact, I was recently talking to a police officer friend and he admitted that if he wanted to commit such a heinous crime (hypothetically of course) he would chose a crowded area and start with a fully loaded pump action shotgun spraying over a hundred high velocity pellets into groups of people with only 7 shots, and then follow that up with two handguns.  He is certain that within a matter of a few minutes there would be over 50 people dead or seriously wounded.  That is a frightening thought.  
            On the other end of the debate, beliefs of the NRA and far right supporters who fear that we have to be prepared for the remote possibility of the evil empire suppressing and dictating helpless American citizens such as previous tyrannies (the Third Reich and Mussolini), is fear mongering ideation.  Is there a possibility of such a future for America?  Of course there is.  However, even without every one of us armed and dangerous, the likelihood of such a radical takeover is slim to none.  And that is also the truth.  Contrary to what radicals think and fear, the President of the United States, whether a democrat or republican; white, black or any shade in between; or a man or woman; is far from a dictator and the means of gaining such authority is nearly impossible.  The founding fathers established our government with the intent of preventing such a tyrannical government.  The President would have to re-write the constitution with the support of both divisions of congress and the judiciary branch.  The military would be called to turn their weapons on their own brothers and sisters.  In addition to the federal government there are 50 independent state governments with similar constitutions.  Each state has its own militia as does their individual cities.  It would be a mass undertaking, involving all levels of corruption, to successfully pull off such a coup. 
Reality is that such fearful ideology is an excuse for something that they want to have, not what they believe they need to have.  There is a difference.  And truth be told, even if we could have any weapon we wanted, unless we owned drone strike capability, F22 Raptors, Apache and Cobra attack helicopters, tanks, laser guided missiles and bunker busters to name a few, we would still be inadequately armed against a tyrannical government.  Unlimited freedom of the second amendment would not protect us. 

I apologize.  Once again, I have rambled too long to get to what I believe is the real issue that has to be solved to prevent additional tragedies like those in Connecticut, Texas and Colorado.  At the heart of the problem is a sickness that is plaguing our society.  It is a mental illness that is unweaving our social fabric resulting in antisocial behaviors.  These vary in severity such as someone’s impatience while they are waiting in an ER for a non life threatening sore throat, trampling people to death during a shopping frenzy, the need to post every bit of useless information about our lives on social media, our need to find happiness by buying ‘things’ with money we don’t have, a wall street predator who will con someone out of their life savings for a commission, our big banks and other corporate executives who expect to be paid millions in bonuses while failing their customers, and even going on a murderous killing spree victimizing innocent people including children.  These are all a symptom of the same disease that is slowly taking away our humanity and our ability to function as a society.

Wednesday, January 16, 2013

A Son for my Gun – Part I



 The 2nd Amendment of the U.S Bill of Rights (adopted Dec. 15, 1791):


A well regulated Militia being necessary to the security of a free state, the right of the people to keep and bear arms shall not be infringed.
                                    --------------------------------------------
I was driving home from work late last night, actually early this morning, and I was listening to the radio.  As with most news broadcasts lately, this interview focused on the recent shooting at Sandy Hook Elementary School in Newton Connecticut.  We all know the horrifying outcome.  Like most Americans, despite which side of the issue you find yourself, such a tragedy has stirred a brew of emotions and simmered them to the surface.  We all have opinions and many of them are at odds with one another – so what do we do?
            I have to admit, I wasn’t simply driving home - I was crying.  I see death all the time at work in the Emergency Room.  My job deals with life and death issues every day.  That is the harsh natural truth of life.  Eventually it all comes to an end.  However, as a human being we deserve the right to chose how our end comes to us.  It should never be stolen from us.
            Over the years I have witnessed children die.  I have faced these tragedies as a professional and have never once shed a tear.  So why was this hardened, cynical ER provider crying?  My tears were from a mother’s story whose son perished in the tragedy.  She recalls finding her young child embraced in the arms of his teacher.  They were both shot.  Her son was literally scared to his death, trying to seek solace in the arms of someone he trusted and believed could save him; someone other than his mother or father, who were not there at his final moments.  My children, as I felt before with my Dad, see me as Superman, yet Superman never came to this child or 19 of his schoolmates.
I immediately envisioned that being my son, and I could not dam the flood of emotions.  Fear, anger, hatred, love and empathy. It was one of the most emotional moments of my life.  All my tears could not wash away how I was feeling and how I still feel.  Feelings I hope we all share.
 
What do we do?  That is the question that everyone is asking.  Is there an easy answer?  Do we repel the second amendment altogether or do nothing and even escalate the issue by arming security guards in every school in American as the NRA has proposed?
I will start by saying that Wayne Lapierre of the NRA made a bone ass suggestion when he recommended armed guards in every American school.  I shook my head in disbelief when he said, “The only way to stop a bad guy with a gun is a good guy with a gun.”  What a jack ass!  With that being said, I will admit that I own guns.  I have a lot of guns.  I even have an assault rifle.  I believe in the Bill of Rights including the right to keep and bear arms, however I have a moderate interpretation of the amendment that our forefathers wrote over 200 years ago. 
I believe I have the right to protect my family from anyone breaking into my house that may do my family harm.  My home is a sanctuary for myself and my family and no one has the right to steal that peace and security away from us.  Do I need an assault rifle for that?  No.  A shotgun will do the job nicely.  So would a revolver with a 6 shot capacity. 
Should I have the right and freedom to walk the public streets of our country carrying a lethal weapon?  Unlike our home which is private and personal, public places are for everyone, and we need to share them in a state of peace and cooperation, especially during times of disagreement.  Carrying that firearm around in public is not a necessary evil.  It is a means for intimidation and creating avoidable immorality.  Many times law abiding citizens, not deranged mental patients, resort to deadly force during an argument in a public place simply because they had the means to do so.   
These individuals support the statement we always hear, “Guns don’t kill people, people kill people,” This pro-gun argument has truth, but guns definitely make it a lot easier to kill people, and to effectively kill a lot of them quickly.  So, what we need is some sort of compromise.  Find a middle ground, that will allow a father to protect his family from someone entering his home to harm his children; yet prevent or at least make it very difficult to allow a ‘normal’ person who suffers from a temporary moment of insanity from killing a mother because of a road rage argument, as well as preventing a deranged individual from deciding to murder masses of people because they forgot to take their medication.  
Why are Americans, normal and mentally ill, resorting to deadly violence?  This is the other issue to the problem.  I believe it is the main issue, the disease that is plaguing this country and I will address this sickness in Part II and I discuss in detail in my book MediSin.
            If it means a safer place for my children, this second amendment advocate will gladly give up my guns for my sons.  I will find other ways to raise my testosterone level and get that adrenaline rush that many of us are truly after.

Buy Niam Hew's new book MediSin NOW!

Sunday, January 6, 2013

Dr. Kevorkian Loves You More Than Your ER Doctor



            A few years ago I was relieving a colleague after he had a long shift in the ER.  I could tell he was tired.  He was working in the ER part time ever since the new CEO of the hospital decided to fire our ER director.  As administrators often do, they solve ‘their issues’ but often create other problems without providing any solutions.  Since our boss and friend had been relieved of his post, the rest of us were running around without any real leadership. 
We were looking for help but our options were limited.  The exception was the physician I was taking over for that day.  He was an excellent provider - honest, caring and intelligent.  He had prior administrative experience; in fact he was the Chief Medical Officer of the hospital.  He was perfect, with only one minor problem – he didn’t want the job. 
My fellow PA’s and I continuously pleaded with him to take the job, but every time we asked we were given a polite ‘no thank-you’.  This morning was no exception; in fact, I think he anticipated my asking.  It was rather slow that morning, so we had a moment to talk.  I outlined the inner problems we were facing in the ER without a director and then gave him all the reasons that he would be the perfect solution.   He politely listened to what I had to say and then gave me his reason why he did not want the job.  He only had one.
“I have my practice.”  He was a board certified family practice physician.  Not able to understand his reservations, I clearly outlined all the benefits of giving up his boring, mundane primary care practice and coming over to the dark side of medicine and work in the ER full time.  Less hours, higher pay, no need to be ‘on call’, no business headaches to worry about such as employee issues, payroll and billing problems.  Simply put it would be less time and headache for more money.  Slam dunk!
He looked at me and agreed with everything I said.  So what was the problem? 
“I like my patients,” he told me. 
I didn’t understand.  “You’ll see plenty of patients here.”
He smiled and shook his head.  “No… I enjoy the relationship I have with my patients in my office.  That’s why I got into medicine in the first place.  I went into family practice because I wanted to connect to the people I care for.  It is important to me to have that relationship.  Without it all I’d be is…”  He trailed off looking for the right thing to say, so I finished it for him, “An ER doctor.”  He gave me a smile because I finally understood.
Although I got his meaning, I could not understand why he wanted to have such a connection to his patients.  The thought was completely alien to me.  This guy was old.  He was from a different time when patients, and people in general, were different – better and nicer.  That had to be the reason, or maybe he was simply a crazy old coot.  What he was telling me was the complete opposite of my goals in practicing medicine.   In fact, I just bought a new stethoscope and I got the longest one possible to limit how close I actually have to come to my patients; the farther away the better.  I do not want to stand within 3 feet of these people, so why would I want to know the personal details regarding their lives?
I dwelled on what my friend had told for the next few days and even weeks.  What he said struck a chord and got me to really examine myself and what I was doing.  What the hell was wrong with me?  I hate patients.  I hate them all, even the nice ones.  This guy wanted to be their friend as well as their doctor.  The thought of such a connection with these pain in the ass, self centered, freaks of nature makes me nauseated.     
I began asking my fellow ER colleagues what they thought of their patients.  I quickly realized I was not alone.  In fact, the overwhelming majority of my cohorts are just as demented as I am.  The beauty of Emergency Medicine is:  get ‘em in, get ‘em out and hopefully never see them again.  It’s the perfect relationship - no strings attached. 
ER providers and nurses have problems with commitment.  Why get into a serious relationship, when you can have a bunch of one night stands.  Yes, ER personnel are immature, selfish people who are simply using you for cheap thrills.  We don’t care, and please, don’t expect us to call. 
So if you aren’t feeling well and are lookin’ for some lovin’ – Don’t go to the ER – take two aspirin and get a dog! 

Buy Niam Hew's new book MediSin NOW!